title: Validation of the new diagnosis grouping system for pediatric emergency department visits using the International Classification of Diseases, 10th Revision.
abstract: OBJECTIVE
  A clinically sensible diagnosis grouping system (DGS) is needed for describing pediatric emergency diagnoses for research, medical resource preparedness, and making national policy for pediatric emergency medical care. The Pediatric Emergency Care Applied Research Network (PECARN) developed the DGS successfully. We developed the modified PECARN DGS based on the different pediatric population of South Korea and validated the system to obtain the accurate and comparable epidemiologic data of pediatric emergent conditions of the selected population.
  
  
  METHODS
  The data source used to develop and validate the modified PECARN DGS was the National Emergency Department Information System of South Korea, which was coded by the International Classification of Diseases, 10th Revision (ICD-10) code system. To develop the modified DGS based on ICD-10 code, we matched the selected ICD-10 codes with those of the PECARN DGS by the General Equivalence Mappings (GEMs). After converting ICD-10 codes to ICD-9 codes by GEMs, we matched ICD-9 codes into PECARN DGS categories using the matrix developed by PECARN group. Lastly, we conducted the expert panel survey using Delphi method for the remaining diagnosis codes that were not matched.
  
  
  RESULTS
  A total of 1879 ICD-10 codes were used in development of the modified DGS. After 1078 (57.4%) of 1879 ICD-10 codes were assigned to the modified DGS by GEM and PECARN conversion tools, investigators assigned each of the remaining 801 codes (42.6%) to DGS subgroups by 2 rounds of electronic Delphi surveys. And we assigned the remaining 29 codes (4%) into the modified DGS at the second expert consensus meeting. The modified DGS accounts for 98.7% and 95.2% of diagnoses of the 2008 and 2009 National Emergency Department Information System data set. This modified DGS also exhibited strong construct validity using the concepts of age, sex, site of care, and seasons. This also reflected the 2009 outbreak of H1N1 influenza in Korea.
  
  
  CONCLUSIONS
  We developed and validated clinically feasible and sensible DGS system for describing pediatric emergent conditions in Korea. The modified PECARN DGS showed good comprehensiveness and demonstrated reliable construct validity. This modified DGS based on PECARN DGS framework may be effectively implemented for research, reporting, and resource planning in pediatric emergency system of South Korea.
authors.affiliation: From the *Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggi; †Department of Emergency Medicine, Seoul National University Boramae Medical Center; ‡Department of Emergency Medicine, Seoul National University College of Medicine; §Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul; ∥Department of Emergency Medicine, Kwandong University College of Medicine and Myongji Hospital, Gyeonggi; ¶Incheonsarang Hospital, Incheon; and #Sejong General Hospital, Seoul, Republic of Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Ki Jeong
authors.initials: KJ
authors.lastname: Hong
authors.forename: Do Kyun
authors.initials: DK
authors.lastname: Kim
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kwak
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Jang
authors.forename: Hahn Bom
authors.initials: HB
authors.lastname: Kim
authors.forename: Hyun
authors.initials: H
authors.lastname: Noh
authors.forename: Jungho
authors.initials: J
authors.lastname: Park
authors.forename: Bongkyu
authors.initials: B
authors.lastname: Song
authors.forename: Jae Yun
authors.initials: JY
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003697:Delphi Technique; D003953:Diagnosis-Related Groups / Q000145:classification*; D004630:Emergencies / Q000145:classification*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D017050:Episode of Care; D005240:Feasibility Studies; D005260:Female; D063005:Health Information Systems / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D038801:International Classification of Diseases; D038622:Internationality; D008297:Male; D009017:Morbidity; D010372:Pediatrics / Q000706:statistics & numerical data*; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult