Background

Column

Purpose

The purpose of this interactive dashboard is to summarise the chief complaint text and diagnosis codes as part of the iterative development cycle, or as part of an initial description of the content of these fields in existing syndromes or categories. The data source used in this dashboard is the Chief Complaint Query Validation (CCQV) data source in NSSP-ESSENCE, which includes the chief complaint and discharge diagnosis fields, and does not include facility location, patient location, or other demographic information. This data source was created with the Syndromic Community of Practice (CoP) so that users can test and create new syndrome categories using a large corpus of chief complaint and diagnosis code data that includes more variation than would be present in any one site. Some sites have opted out of contributing their data to the Query Validation data source, including Arizona, Idaho, Illinois, Marion County, Indiana, Massachusetts, North Dakota, and Ohio.

Interactive Visualizations

The visualizations in this dashboard include total weekly volume of encounters, the 200 most frequent n-gram frequencies of chief complaint terms and discharge diagnosis codes, and term co-occurrence network graphs for the ChiefComplaintParsed and CCDD fields. Potential clusters or groupings of terms are visualized by node color and can be selected from the “Select by group” drop down menu. All widgets were produced with the Plotly and visNetwork packages which provide hovering functionality such as displaying data point values, ICD-10 code descriptions, and co-occurrence frequencies.

Query Details

Fields	Query
CCDD	(,^[;/ ]J70.5^,or,^[;/ ]J705^,or,^[;/ ]X08.8^,or,^[;/ ]X088^,or,^[;/ ]X01.1^,or,^[;/ ]X011^,or,^[;/ ]T59.81^,or,^[;/ ]T5981^,or,^[;/ ]423123007[;/ ]^,or,^[;/ ]508.2^,or,^[;/]5082[;/]^,or,^[;/ ]E898.1^,or,^[;/ ]E8981^,or,^[;/ ]E892^,or,^[;/ ]426936004[;/ ]^,or,^[;/ ]217486005[;/ ]^,or,^wild fire^,or,^wildfire^,or,(,^smoke ^,andnot,(,^ a smoke^,or,^ to smoke^,or,^alarm^,or,^can smoke^,or,^denies smoke^,or,^detector^,or,^did smoke^,or,^does not smoke^,or,^does smoke^,or,^go and smoke^,or,^go smoke^,or,^he smoke^,or,^husband smoke^,or,^n_t smoke^,or,^never smoke^,or,^no smoke^,or,^or smoke^,or,^out and smoke^,or,^outside and smoke^,or,^secondhand^,or,^second hand^,or,^smoke bomb^,or,^smoke shop^,or,^smoke week^,or,^smoke[drs]^,or,^smoke^a lot^,or,^they smoke^,or,^upstairs and smoke^,or,^was smoking^,or,^wife smoke^,or,^without smoke^,or,^blunt^,or,^joint^,),),),andnot,(,^canab^,or,^vape^,or,^cannab^,or,^cig^,or,^crack^,or,^her[io][oi]n^,or,!k2!,or,^marij^,or,!meth!,or,!pot!,or,^spice^,or,^tobac^,or,^weed^,or,^normal saline^,or,^ on fire^,or,^cooking^,or,^kitchen^,or,!stove!,or,!oven!,or,^motor [bc]^,or,^motor[bc]^,or,(,^motor vehicle^,and,(,^collision^,or,^accident^,or,^crash^,),),)

Fields

Query

CCDD

(,^[;/ ]J70.5^,or,^[;/ ]J705^,or,^[;/ ]X08.8^,or,^[;/ ]X088^,or,^[;/ ]X01.1^,or,^[;/ ]X011^,or,^[;/ ]T59.81^,or,^[;/ ]T5981^,or,^[;/ ]423123007[;/ ]^,or,^[;/ ]508.2^,or,^[;/]5082[;/]^,or,^[;/ ]E898.1^,or,^[;/ ]E8981^,or,^[;/ ]E892^,or,^[;/ ]426936004[;/ ]^,or,^[;/ ]217486005[;/ ]^,or,^wild fire^,or,^wildfire^,or,(,^smoke ^,andnot,(,^ a smoke^,or,^ to smoke^,or,^alarm^,or,^can smoke^,or,^denies smoke^,or,^detector^,or,^did smoke^,or,^does not smoke^,or,^does smoke^,or,^go and smoke^,or,^go smoke^,or,^he smoke^,or,^husband smoke^,or,^n_t smoke^,or,^never smoke^,or,^no smoke^,or,^or smoke^,or,^out and smoke^,or,^outside and smoke^,or,^secondhand^,or,^second hand^,or,^smoke bomb^,or,^smoke shop^,or,^smoke week^,or,^smoke[drs]^,or,^smoke^a lot^,or,^they smoke^,or,^upstairs and smoke^,or,^was smoking^,or,^wife smoke^,or,^without smoke^,or,^blunt^,or,^joint^,),),),andnot,(,^canab^,or,^vape^,or,^cannab^,or,^cig^,or,^crack^,or,^her[io][oi]n^,or,!k2!,or,^marij^,or,!meth!,or,!pot!,or,^spice^,or,^tobac^,or,^weed^,or,^normal saline^,or,^ on fire^,or,^cooking^,or,^kitchen^,or,!stove!,or,!oven!,or,^motor [bc]^,or,^motor[bc]^,or,(,^motor vehicle^,and,(,^collision^,or,^accident^,or,^crash^,),),)

Column

Total Number of Encounters

11805

Date Range

June 28, 2020 to November 08, 2020

Total Weekly Volume of Encounters from Query Validation Data Source -ESSENCE

Chief Complaint

Column

Weekly Mean Number of Characters in Chief Complaint Field

Weekly Median Number of Characters in Chief Complaint Field

Column

Weekly Mean Number of Tokens in Chief Complaint Field

Weekly Median Number of Tokens in Chief Complaint Field

Discharge Diagnosis

Column

Weekly Mean Number of Characters in Discharge Diagnosis Field

Weekly Median Number of Characters in Discharge Diagnosis Field

Column

Weekly Mean Number of Tokens in Discharge Diagnosis Field

Weekly Median Number of Tokens in Discharge Diagnosis Field

Unigram

Column

Chief Complaint

Column

Discharge Diagnosis

Bigram

Column

Chief Complaint

Column

Discharge Diagnosis

Trigram

Column

Chief Complaint

Column

Discharge Diagnosis

Chief Complaint

Chief Complaint Parsed Term Co-occurrence Network Graph

Chief Complaint and Discharge Diagnosis

CCDD Term Co-occurrence Network Graph

Increasing Unigrams

Trends represent the proportion of term occurrences on a weekly time resolution. The numerator is the number of occurrences of the term in a specific week, while the denominator is the sum of all term frequencies in that week. A binomial model is fit to each time series to determine if term occurrence has changed significantly over time. Terms with a positive slope (test statistic) and adjusted p-value < 0.01 are categorized as having significant increase, while terms with a negative slope and adjusted p-value < 0.01 are categorized as having significant decrease.

Column

Change in Individual CC Term Trends - Increasing

Chief Complaint Unigram	Statistic	Adjusted p-value
EFFECT	8.03	9.57e-16
TOXIC	8.01	1.13e-15
UNINTENTIONAL	7.88	3.33e-15
ACCIDENTAL	7.63	2.33e-14
SMOKE	7.56	4.09e-14
ENCOUNTER	6.66	2.67e-11
INITIAL	6.51	7.37e-11
INHALATION	6.08	1.18e-09
HEADACHE	4.08	4.45e-05
SHORTNESS	4.06	4.82e-05
EXPOSURE	3.99	6.48e-05
BREATH	3.80	1.46e-04
COUGH	3.47	5.21e-04
ALCOHOL	2.88	3.99e-03
VISIT	2.65	8.04e-03

Column

Change in Individual DD Term Trends - Increasing

ICD-10 Unigram	Description	Statistic	Adjusted p-value
T59811A	Toxic effect of smoke, accidental (unintentional), initial encounter	27.84	1.32e-170
Z20828	Contact with and (suspected) exposure to other viral communicable diseases	5.72	1.09e-08
R05	Cough	3.92	8.95e-05
J45901	Unspecified asthma with (acute) exacerbation	3.90	9.71e-05
X011XXA	Exposure to smoke in uncontrolled fire, not in building or structure, initial encounter	3.29	9.93e-04
J9801	Acute bronchospasm	3.23	1.25e-03
J069	Acute upper respiratory infection, unspecified	3.18	1.49e-03
E876	Hypokalemia	2.99	2.8e-03
U071	COVID-19, virus identified	2.92	3.48e-03
J209	Acute bronchitis, unspecified	2.86	4.29e-03
R0603	Acute respiratory distress	2.80	5.08e-03
E892	Postprocedural hypoparathyroidism	2.80	5.16e-03

Decreasing Unigrams

Trends represent the proportion of term occurrences on a weekly time resolution. The numerator is the number of occurrences of the term in a specific week, while the denominator is the sum of all term frequencies in that week. A binomial model is fit to each time series to determine if term occurrence has changed significantly over time. Terms with a positive slope (test statistic) and adjusted p-value < 0.01 are categorized as having significant increase, while terms with a negative slope and adjusted p-value < 0.01 are categorized as having significant decrease.

Column

Change in Individual CC Term Trends - Decreasing

Chief Complaint Unigram	Statistic	Adjusted p-value
FIREWORK	-8.35	6.82e-17
BURN	-7.71	1.26e-14
FIREWORKS	-6.15	7.64e-10
HAND	-5.19	2.1e-07
INJURY	-4.94	7.77e-07
LEG	-4.67	2.95e-06
WOUND	-4.19	2.77e-05
ARM	-3.92	8.89e-05
FOOT	-3.60	3.15e-04
EYE	-3.51	4.52e-04
MULTIPLE	-3.31	9.48e-04
BURNS	-3.29	9.93e-04
CONDITIONS	-3.28	1.05e-03
LOWER	-3.11	1.9e-03
FINGERS	-2.85	4.44e-03
ACCIDENT	-2.68	7.41e-03
PATIENT	-2.63	8.62e-03

Column

Change in Individual DD Term Trends - Decreasing

ICD-10 Unigram	Description	Statistic	Adjusted p-value	Trend
W39XXXA	Discharge of firework, initial encounter	-11.05	2.09e-28
J705	Respiratory conditions due to smoke inhalation	-10.46	1.34e-25
X088XXA	Exposure to other specified smoke, fire and flames, initial encounter	-8.84	9.9e-19
Y9389	Activity, other specified	-5.10	3.34e-07
Y929	Unspecified place or not applicable	-4.78	1.74e-06
Z1159	Encounter for screening for other viral diseases	-4.65	3.34e-06
T310	Burns involving less than 10% of body surface	-4.26	2.01e-05
T24231A	Burn of second degree of right lower leg, initial encounter	-4.11	4.02e-05
T23241A	Burn of second degree of multiple right fingers (nail), including thumb, initial encounter	-4.00	6.36e-05
Y9289	Other specified places as the place of occurrence of the external cause	-3.72	1.98e-04
Y93G2	Activity, grilling and smoking food	-3.53	4.15e-04
T24031A	Burn of unspecified degree of right lower leg, initial encounter	-3.40	6.84e-04
T23252A	Burn of second degree of left palm, initial encounter	-3.13	1.77e-03
T23242A	Burn of second degree of multiple left fingers (nail), including thumb, initial encounter	-3.05	2.32e-03
R51	Headache	-3.04	2.37e-03
T24232A	Burn of second degree of left lower leg, initial encounter	-2.96	3.07e-03
T24202A	Burn of second degree of unspecified site of left lower limb, except ankle and foot, initial encounter	-2.90	3.71e-03
T23221A	Burn of second degree of single right finger (nail) except thumb, initial encounter	-2.87	4.16e-03
T2642XA	Burn of left eye and adnexa, part unspecified, initial encounter	-2.79	5.3e-03
T2102XA	Burn of unspecified degree of abdominal wall, initial encounter	-2.79	5.34e-03
T22232A	Burn of second degree of left upper arm, initial encounter	-2.77	5.56e-03
T24211A	Burn of second degree of right thigh, initial encounter	-2.76	5.76e-03
T2007XA	Burn of unspecified degree of neck, initial encounter	-2.71	6.77e-03