ORCID Profile
0000-0002-3953-7724
Current Organisations
Queensland University of Technology Faculty of Health
,
Queensland University of Technology
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Publisher: Informa UK Limited
Date: 14-06-2014
DOI: 10.1080/17457300.2013.806558
Abstract: A retrospective, descriptive analysis of a s le of children under 18 years presenting to a hospital emergency department (ED) for treatment of an injury was conducted. The aim was to explore characteristics and identify differences between children assigned abuse codes and children assigned unintentional injury codes using an injury surveillance database. Only 0.1% of children had been assigned the abuse code and 3.9% a code indicating possible abuse. Children between 2 and 5 years formed the largest proportion of those coded to abuse. Superficial injury and bruising were the most common types of injury seen in children in the abuse group and the possible abuse group (26.9% and 18.8%, respectively), whereas those with unintentional injury were most likely to present with open wounds (18.4%). This study demonstrates that routinely collected injury surveillance data can be a useful source of information for describing injury characteristics in children assigned abuse codes compared to those assigned no abuse codes.
Publisher: Oxford University Press (OUP)
Date: 03-2010
Abstract: The accuracy of cause-of-death statistics substantially depends on the quality of cause-of-death information in death certificates, primarily completed by medical doctors. Deficiencies in cause-of-death certification have been observed across the world, and over time. Despite educational interventions targeted at improving the quality of death certification, their intended impacts are rarely evaluated. This review aims to provide empirical evidence that could guide the modification of existing educational programmes, or the development of new interventions, which are necessary to improve the capacity of certifiers as well as the quality of cause-of-death certification, and thereby, the quality of mortality statistics. A literature review using keywords: death certification education/training. The primary search through PubMed. Reference lists in in idual articles from the primary search and also manual searching of other databases such as Google Scholar and OpenDOAR. Evaluation studies which assessed educational interventions for medical students and doctors on correct completion of death certificates. All educational interventions identified in this review improved certain aspects of death certification although the statistical significance of evaluation results varies with the type of intervention: printed educational material alone being the intervention with the least educational impact and interactive workshops being the most effective intervention. Pragmatic education on best practice for cause-of-death certification is a basic step to ensure accurate information for each in idual case, leading to the production of high quality mortality statistics for epidemiology, public health policy and research. Development of new educational interventions or modification of existing programmes should be based on evidence of the benefits from current and past interventions provided under varying circumstances.
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.CHIABU.2009.08.005
Abstract: The objectives of this article are to explore the extent to which the International Statistical Classification of Diseases and Related Health Problems (ICD) has been used in child abuse research, to describe how the ICD system has been applied, and to assess factors affecting the reliability of ICD coded data in child abuse research. PubMed, CINAHL, PsychInfo and Google Scholar were searched for peer reviewed articles written since 1989 that used ICD as the classification system to identify cases and research child abuse using health databases. Snowballing strategies were also employed by searching the bibliographies of retrieved references to identify relevant associated articles. The papers identified through the search were independently screened by two authors for inclusion, resulting in 47 studies selected for the review. Due to heterogeneity of studies meta-analysis was not performed. This paper highlights both utility and limitations of ICD coded data. ICD codes have been widely used to conduct research into child maltreatment in health data systems. The codes appear to be used primarily to determine child maltreatment patterns within identified diagnoses or to identify child maltreatment cases for research. A significant impediment to the use of ICD codes in child maltreatment research is the under ascertainment of child maltreatment by using coded data alone. This is most clearly identified and, to some degree, quantified, in research where data linkage is used. The importance of improved child maltreatment identification will assist in identifying risk factors and creating programs that can prevent and treat child maltreatment and assist in meeting reporting obligations under the CRC.
Publisher: Wiley
Date: 11-1995
Publisher: BMJ
Date: 06-2009
Abstract: To assess extent of coder agreement for external causes of injury using ICD-10-AM for injury-related hospitalisations in Australian public hospitals. A random s le of 4850 discharges from 2002 to 2004 was obtained from a stratified random s le of 50 hospitals across four states in Australia. On-site medical record reviews were conducted and external cause codes were assigned blinded to the original coded data. Code agreement levels were grouped into the following agreement categories: block level, 3-character level, 4-character level, 5th-character level, and complete code level. At a broad block level, code agreement was found in over 90% of cases for most mechanisms (eg, transport, fall). Percentage disagreement was 26.0% at the 3-character level agreement for the complete external cause code was 67.6%. For activity codes, the percentage of disagreement at the 3-character level was 7.3% and agreement for the complete activity code was 68.0%. For place of occurrence codes, the percentage of disagreement at the 4-character level was 22.0% agreement for the complete place code was 75.4%. With 68% agreement for complete codes and 74% agreement for 3-character codes, as well as variability in agreement levels across different code blocks, place and activity codes, researchers need to be aware of the reliability of their specific data of interest when they wish to undertake trend analyses or case selection for specific causes of interest.
Publisher: SAGE Publications
Date: 03-2012
DOI: 10.1177/183335831204100101
Abstract: The World Health Organization (WHO) recommends that data on mortality in its member countries are collected utilising the Medical Certificate of Cause of Death published in the instruction volume of the ICD- 10. However, investment in health information processes necessary to promote the use of this certificate and improve mortality information is lacking in many countries. An appeal for support to make improvements has been launched through the Health Metrics Network's MOVE-IT strategy (Monitoring of Vital Events - Information Technology) (WHO 2011). Despite this international spotlight on the need for capture of mortality data and in the use of the ICD-10 to code the data reported on such certificates, there is little cohesion in the way that certifiers of deaths receive instruction in how to complete the death certificate, which is the main source document for mortality statistics. Complete and accurate documentation of the immediate, underlying and contributory causes of death of the decedent on the death certificate is a requirement to produce standardised statistical information and to the ability to produce cause-specific mortality statistics that can be compared between populations and across time. This paper reports on a research project conducted to determine the efficacy and accessibility of the certification module of the WHO's newly-developed web based training tool for coders and certifiers of deaths. Involving a population of medical students from the Fiji School of Medicine and a pre- and post-research design, the study entailed completion of death certificates based on vignettes before and after access to the training tool. The ability of the participants to complete the death certificates and analysis of the completeness and specificity of the ICD-10 coding of the reported causes of death were used to measure the effect of the students' learning from the training tool. The quality of death certificate completion was assessed using a Quality Index before and after the participants accessed the training tool. In addition, the views of the participants about accessibility and use of the training tool were elicited using a supplementary questionnaire. The results of the study demonstrated improvement in the ability of the participants to complete death certificates completely and accurately according to best practice. The training tool was viewed very positively and its implementation in the curriculum for medical students was encouraged. Participants also recommended that interactive discussions to examine the certification exercises would be an advantage.
Publisher: Wiley
Date: 04-2003
DOI: 10.1046/J.1445-5994.2003.00354.X
Abstract: To characterize long-term mortality trends for infectious and parasitic diseases in Australia during the twentieth century, explore influencing factors and provide suggestions to health policy-makers. A descriptive study was conducted. Deaths due to communicable diseases from 1907 to 1997 were tallied, according to the International Classification of Diseases version 9 (ICD-9). Trends in infectious disease mortality in overall population and in the 0-4 years age group were examined and standardized by sex. Death rates were also studied for: (i) diarrhoea/enteritis, (ii) pneumonia and all respiratory diseases and (iii) tuberculosis. There has been a substantial decline in -mortality from communicable diseases over the study period. The death rate dropped from 258.9 per 100,000 population in 1907 to 7.2 per 100,000 population in 1997. Six phases of the decline were observed. A combination of improved living conditions and access to readily available treatments over the twentieth century played an important role in the reduction of infectious disease mortality in Australia.
Publisher: Elsevier BV
Date: 02-2004
Publisher: Springer Science and Business Media LLC
Date: 18-05-2018
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1016/J.AAP.2007.09.008
Abstract: Complete and accurate information about hospitalised injuries is essential for injury risk and outcome research, though the accuracy and reliability of hospital data for injury surveillance are often questioned. To ascertain clinical coders' views of the reasons for a lack of specificity in external cause code usage and ways to improve external cause coding, a nationwide survey of coders was conducted in Australia in 2006. Four hundred and two coders participated in the questionnaire. The results of this study show that discharge summaries and doctors' notes were the poorest source of information regarding external causes, place of injury occurrence, and activity at the time of injury. Coders viewed missing external cause information and missing documentation as having the greatest impact on the quality of external cause coding. A large majority of coders suggested that improving clinical documentation in the emergency department and introducing a centralised structured form for external cause information would improve the quality of external cause coding. Clinical coders are a valuable source of information regarding problems with, and solutions to the collection of high quality data and this research has highlighted several areas where improvements can be made and further research is needed.
Publisher: MDPI AG
Date: 07-07-2016
Publisher: SAGE Publications
Date: 27-04-2017
Abstract: Differential uptake of, or access to, personal electronic health records (PEHRs) has the potential to impact on health disparities among certain social groups. In 2012, the Australian Government introduced the Personally Controlled Electronic Health Record (PCEHR), an opt-in system operated by the then National E-Health Transition Authority (NEHTA). In July 2016, the My Health Record (MyHR), an opt-out model, operated by the Australian Digital Health Agency replaced the PCEHR, providing additional support for consumers. This research was carried out between 2012 and 2015, covering the opt-in PCEHR phase. The aim of the study was to explore demographic characteristics of Australian health consumers who were first to register for a PEHR, and to identify the age and gender populations less likely to register for a PEHR in the opt-in format. The study aimed to provide early data on registrants and potential methods to encourage in iduals to register for a PEHR. A cross-sectional study investigated differences in registrations for PEHRs from 2012 to 2015 by age and sex. Results revealed that males were less likely to register than females, and adolescents of both sexes were the least likely to register when compared with any other age group. Similarly, middle-aged males had among the lowest reported registrations, as did older females. While e-health has the potential to improve health outcomes and PEHRs the potential to empower consumers to better manage their health and improve their access health services, evidence from this study suggested that some population groups that experience health inequalities (e.g. older people) were underrepresented among registrants for PEHRs. As income, ethnicity and education are major drivers for health disparities in Australia, future research should focus on uptake and use of PEHRs (now the MyHR) from the perspective of these variables.
Publisher: BMJ
Date: 02-2009
Abstract: To appraise the published evidence regarding the accuracy of external cause-of-injury codes in hospital records. Systematic review. Electronic databases searched included PubMed, PubMed Central, Medline, CINAHL, Academic Search Elite, Proquest Health and Medical Complete, and Google Scholar. Snowballing strategies were used by searching the bibliographies of retrieved references to identify relevant associated articles. Studies were included in the review if they assessed the accuracy of external cause-of-injury coding in hospital records via a recoding methodology. The papers identified through the search were independently screened by two authors for inclusion. Because of heterogeneity between studies, meta-analysis was not performed. Very limited research on the accuracy of external cause coding for injury-related hospitalisation using medical record review and recoding methodologies has been conducted, with only five studies matching the selection criteria. The accuracy of external cause coding using ICD-9-CM ranged from approximately 64% when exact code agreement was examined to approximately 85% when agreement for broader groups of codes was examined. Although broad external cause groupings coded in ICD-9-CM can be used with some confidence, researchers should exercise caution for very specific codes until further research is conducted to validate these data. As all previous studies have been conducted using ICD-9-CM, research is needed to quantify the accuracy of coding using ICD-10-AM, and validate the use of these data for injury surveillance purposes.
Publisher: Elsevier BV
Date: 02-2006
DOI: 10.1016/J.MOLBIOPARA.2005.10.008
Abstract: Parasites of the Leishmania Viannia subgenus are major causative agents of mucocutaneous leishmaniasis (MCL), a disease characterised by parasite dissemination (metastasis) from the original cutaneous lesion to form debilitating secondary lesions in the nasopharyngeal mucosa. We employed a protein profiling approach to identify potential metastasis factors in laboratory clones of L. (V.) guyanensis with stable phenotypes ranging from highly metastatic (M+) through infrequently metastatic (M+/M-) to non-metastatic (M-). Comparison of the soluble proteomes of promastigotes by two-dimensional electrophoresis revealed two abundant protein spots specifically associated with M+ and M+/M- clones (Met2 and Met3) and two others exclusively expressed in M- parasites (Met1 and Met4). The association between clinical disease phenotype and differential expression of Met1-Met4 was less clear in L. Viannia strains from mucosal (M+) or cutaneous (M-) lesions of patients. Identification of Met1-Met4 by biological mass spectrometry (LC-ES-MS/MS) and bioinformatics revealed that M+ and M- clones express distinct acidic and neutral isoforms of both elongation factor-1 subunit beta (EF-1beta) and cytosolic tryparedoxin peroxidase (TXNPx). This interchange of isoforms may relate to the mechanisms by which the activities of EF-1beta and TXNPx are modulated, and/or differential post-translational modification of the gene product(s). The multiple metabolic functions of EF-1 and TXNPx support the plausibility of their participation in parasite survival and persistence and thereby, metastatic disease. Both polypeptides are active in resistance to chemical and oxidant stress, providing a basis for further elucidation of the importance of antioxidant defence in the pathogenesis underlying MCL.
Publisher: Elsevier BV
Date: 07-2004
Publisher: Elsevier BV
Date: 09-2004
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1111/J.1753-6405.2008.00187.X
Abstract: To highlight issues relating to suicide coding that have an impact on the final reported mortality data by the Australian Bureau of Statistics. This paper presents an outline of the way in which the official Australian suicide data is captured and coded and highlights issues relating to the classification used, coronial processes, documentation requirements and data sources that have an impact on the final reported data, especially deaths associated with coronial investigations. Issues related to the coding of Australian suicide data are: *Disparity between jurisdictions due to differences in documentation about accidental or undetermined causes of death. *Lack of standardisation in the way that coronial deaths are reported across Australia. *Lack of a standard form for police reports. *Administrative processes that cause delays in reporting the results of coronial investigations. *Reluctance on the part of some coroners to report deaths as suicides. Researchers and policy makers need to be aware of the constraints under which suicide can be reported as such in the official data before interpreting time trends.
Publisher: Public Library of Science (PLoS)
Date: 25-01-2018
Publisher: Australasian College of Health Service Management
Date: 29-07-2020
Abstract: Global health systems are under immense pressure with the exponential growth and spread of COVID-19. Public health and health system responses to the pandemic have relied on health information reporting, visualisation, and projections of incidence, morbidity, and mortality. This commentary aims to explore how health information has been used to inform the public, manage risk, understand capacity, prepare the health system and to plan public health strategy. We also aim to share the health information challenges and our insights to inform future debate and strategic investment. This paper will be relevant to health service and health information managers wanting to understand vulnerabilities and focus for future health information initiatives.
Publisher: SAGE Publications
Date: 12-2003
DOI: 10.1177/183335830303100403
Abstract: Developments in information technology will drive the change in records management however, it should be the health information managers who drive the information management change. The role of health information management will be challenged to use information technology to broker a range of requests for information from a variety of users, including health consumers. The purposes of this paper are to conceptualise the role of health information management in the context of a technologically driven and managed health care environment, and to demonstrate how this framework has been used to review and develop the undergraduate program in health information management at the Queensland University of Technology.
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1111/J.1467-842X.2006.TB00777.X
Abstract: This research identifies the level of specificity of cause-of-injury morbidity data in Australia. The research explores reasons for poor-quality data across different causes-of-injury areas, including a lack of clinical documentation and insufficient detail in the classification system. The 2002/03 hospital morbidity dataset of 593,079 injury-related hospital admissions was analysed to examine the specificity of coded external cause-of-injury data. While overall specificity appeared high, the cause of 47,660 injuries was not specifically defined according to the code assigned. Only 56% of cases for whom injury was the result of an accidental fall were assigned a specific code to identify the causal detail 19% were assigned an 'Other Specified' fall code, suggesting a lack of specific code availability and 25% were assigned an 'Unspecified Fall' code, suggesting a lack of clinical documentation to facilitate code selection. To improve the quality of injury-related hospital morbidity data, two main areas to focus resources are: 1) the development of more specific cause-of-injury codes and 2) the provision of more detailed documentation from clinicians. Clinicians and clinical coders need to work together to improve the quality of injury-related coded data through the provision of specific codes and improved clinical documentation. Accurate and comprehensive data pertaining to the circumstances surrounding hospitalised injury events will benefit injury prevention and surveillance initiatives, provide justification for resources related to injury hospitalisation, and assist in external cause research in Australia.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2010
Abstract: The systematic collection of high-quality mortality data is a prerequisite in designing relevant drowning prevention programmes. This descriptive study aimed to assess the quality (i.e., level of specificity) of cause-of-death reporting using ICD-10 drowning codes across 69 countries. World Health Organization (WHO) mortality data were extracted for analysis. The proportion of unintentional drowning deaths coded as unspecified at the 3-character level (ICD-10 code W74) and for which the place of occurrence was unspecified at the 4 th character (.9) were calculated for each country as indicators of the quality of cause-of-death reporting. In 32 of the 69 countries studied, the percentage of cases of unintentional drowning coded as unspecified at the 3-character level exceeded 50%, and in 19 countries, this percentage exceeded 80% in contrast, the percentage was lower than 10% in only 10 countries. In 21 of the 56 countries that report 4-character codes, the percentage of unintentional drowning deaths for which the place of occurrence was unspecified at the 4 th character exceeded 50%, and in 15 countries, exceeded 90% in only 14 countries was this percentage lower than 10%. Despite the introduction of more specific subcategories for drowning in the ICD-10, many countries were found to be failing to report sufficiently specific codes in drowning mortality data submitted to the WHO.
Publisher: Oxford University Press (OUP)
Date: 11-2011
Abstract: The International Classification of Diseases (ICD) is used to categorize diseases, injuries, and external causes of injury, and it is a key epidemiologic tool enabling storage and retrieval of data from health and vital records to produce core international mortality and morbidity statistics. The ICD is updated periodically to ensure the classification system remains current, and work is now under way to develop the next revision, ICD-11. It has been almost 20 years since the last ICD edition was published and over 60 years since the last substantial structural revision of the external causes chapter. Revision of such a critical tool requires transparency and documentation to ensure that changes made to the classification system are recorded comprehensively for future reference. In this paper, the authors provide a history of the development of external causes classification and outline the external cause structure. They discuss approaches to manage ICD-10 deficiencies and outline the ICD-11 revision approach regarding the development of, rationale for, and implications of proposed changes to the chapter. Through improved capture of external cause concepts in ICD-11, a stronger evidence base will be available to inform injury prevention, treatment, rehabilitation, and policy initiatives to ultimately contribute to a reduction in injury morbidity and mortality.
Publisher: SAGE Publications
Date: 09-07-2022
Abstract: Clinical documentation is a fundamental component of patient care. The transition from paper based to electronic medical records/electronic health records has highlighted a number of issues associated with documentation practices including duplication. Developing new ways to document the care provided to patients and in turn, persuading clinicians to accept a change, must be supported by evidence that a change is required. In Australia, there has been a limited number of studies exploring the clinical documentation practices and beliefs of clinicians. To gain an in-depth understanding of clinician documentation practices. A qualitative design using semi-structured interviews with clinicians (allied health professionals, doctors (physicians) and nurses) working in a tertiary-level hospital in South-East Queensland, Australia. Several themes emerged from the data: environmental factors, including departmental policy and systemic issues, and personal factors, including verification, clinical reasoning and experience influencing documentation practices. Our study identified that the documentation practices of clinicians are complex, being driven by both environmental and systemic factors and personal factors. This in turn leads to duplication and some redundancy. The documentation burden of duplication could be reduced by changes in policy, supported by multidisciplinary documentation procedures and electronic systems aligned with clinician workflows, while retaining some flexible documentation practices. The documentation practices of in iduals, when considered from the perspective of enhancing quality care, are considered legitimate and therefore will continue to form part of the health (medical) record regardless of the format.
Publisher: SAGE Publications
Date: 07-2007
Publisher: BMJ
Date: 08-2007
Location: Australia
No related grants have been discovered for Susan Walker.