2.2



Web Appendix MaterialIncidence of neuromyelitis optica spectrum disorder (NMOSD) in China: a national population-based study Section 1 Data Collection and Quality Control .................................................................................................2 Section 2 Analysis protocol ...............................................................................................................................16Appendix Table 1 The number of tertiary hospitals involved in each province in this study............... ............17 Appendix Figure 1 The geographical distribution of 1665 tertiary hospitals in this study ................................18 Section 1 Data Collection and Quality Control of HQMS1. Overview of The Hospital Quality Monitoring System (HQMS) in China The Hospital Quality Monitoring System (HQMS) is an online data collection system launched for medical care measurement and improvement by the Chinese government in 2011. The system is designed to link hospital information systems and to upload a common dataset of information from all inpatient medical records. The HQMS covers all tertiary hospitals over the country, and inpatient data from each tertiary hospital can automatically electronically captured and uploaded. The basic information of HQMS is comparable to the claimant data required by the Centers for Medicare & Medicaid Services in the USPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5KaWFuZzwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 2-4. The HQMS’s nationwide and unique patient identification system allows for information linkage across barriers of time and locale; a relevant and necessary feature given China’s enormous population mobility.2. Data Collection Standard for Medical Record Homepage in Each Tertiary Public Hospitals (related to this study)No.Data Collection itemCodeType LengthRemarkInstitution codeA01Character22Refers to the institution code on the practice license of medical institutionMedical institution name A02Character80Refers to the name of the medical institution where the patient is hospitalized, according to the name of the institution registered on the ‘The Practice License of Medical Institution’ Medical record numberA48Character50Number of hospitalizationsA49Number4An integer greater than 0Admission timeB12DateFormat yyyy-MM-dd HH: mm: ss; the admission time should not be later than the discharge timeDischarge timeB15DateFormat yyyy-MM-dd HH: mm: ssHealth card numberA47Character50Fill in the health card number in the area where the "Health Card of China" has been issued uniformly, or fill in "-" in the areas where the "Health Card" has not been issued.Medical payment methodA46CCharacter3Threshold reference range RC032.NameA11Character40GenderA12CNumber1Threshold reference range RC001Date of birthA13Date10Format yyyy-MM-ddAge (year old)A14Number3The age at which a patient is admitted refers to the calendar age calculated on the calendar when the patient is admitted to the hospital. An integer greater than or equal to 0NationalityA15CCharacter40Marital statusA21CCharacter1Threshold reference range RC002OccupationA38CCharacter2Threshold reference range RC003Ethnic groupA19CCharacter2Threshold reference range RC035Identity numberA20Character18Inpatients must fill in 15 or 18 ID numbers when they are admittedBirthplaceA22Character200Native province (autonomous region, municipality)A23CCharacter50Threshold reference range RC036Registered residence addressA24Character200Registered permanent residence zip codeA25CCharacter66 digitsCurrent addressA26Character200Current address phone numberA27Character40Current address zip codeA28CCharacter66 digitsWork unit and addressA29Character200Work unit phone number A30Character20Work unit zip codeA31CCharacter66 digitsContact nameA32Character40Contact relationshipA33CCharacter1Threshold reference range RC033Contact addressA34Character200Admission wayB11CCharacter1Threshold reference range RC026Admission departmentB13CCharacter6Threshold reference range RC023Admission wardB14Character30Transfer departmentB21CSetMultiple choicesThreshold reference range RC023；When passing through multiple departments, the values are separated by commas.Discharge departmentB16CCharacter6Threshold reference range RC023Discharge wardB17Character30Length of stay in hospitalB20Number6An integer greater than 0. The admission time and discharge time are only calculated for one day. For example: admitted on June 12, 2018, and discharged on June 15, 2018, the length of stay in hospital is 3 days.Outpatient (emergency) diagnosis codeC01CCharacter20Use the International Classification of Diseases, 10th revision (ICD-10)Outpatient (emergency) diagnosis C02NCharacter100Use ICD-10 and the corresponding diagnosis name Primary discharge diagnosis code C03CCharacter20Use ICD-10Primary discharge diagnosis C04NCharacter100Use ICD-10 and the corresponding diagnosis name Admission condition of primary discharge diagnosis C05CCharacter1Threshold reference range RC027Other discharge diagnosis code C06x01CCharacter20Use ICD-10Other discharge diagnosis C07x01NCharacter100Use ICD-10 and the corresponding diagnosis nameAdmission condition of other discharge diagnosis C08x01CCharacter1Threshold reference range RC027Pathological diagnosis codeC09CCharacter20The Second Edition of the International Classification of Diseases for Oncology (M code) is used; it is required when the first letter of the primary diagnosis ICD code is C or D00-D48.Pathological diagnosis nameC10NCharacter100Second Edition of the International Classification of Diseases for Oncology (M code) and the pathological name corresponding to the code; the primary diagnosis ICD code must be C or D00-D48.Pathology numberC11Character50Required if there is a pathological diagnosis code.Drug allergy or notC24CCharacter1Threshold reference range RC037Allergic drug nameC25Character200Required if " Drug Allergy" is "Yes"; multiple drugs are separated by commasChief directorB22Character40Chief (co-chief) doctorB23Character40Doctor-in-chargeB24Character40Resident doctorB25Character40Nurse-in- chargeB26Character40Intern doctorB28Character40CoderB29Character40Medical record qualityB30CCharacter1Threshold reference range RC011Quality Control DoctorB31Character40Quality Control NurseB32Character40Quality control dateB33DateFormat yyyy-MM-ddAutopsy of dead patientsC34CCharacter1Threshold reference range RC016ABO blood groupC26CCharacter1Threshold reference range RC030Rh blood groupC27CCharacter1Threshold reference range RC031Age under 1 year (day)A16Number3Fill in the number of days of actual age. Fill in when the age is less than 1 year old. The age value A14 should be 0. The value range is greater than or equal to 0 and less than 365. The time of admission minus the date of birth is rounded up to 0.Newborn birth weight (g)A18x01Number6The weight of a newborn should be accurate to 10 grams; the weight should be weighed within one hour after the live birth. 1. Fill in the medical records of the mother and the newborn. From birth to 28 days is the neonatal period. For the weight of the twins and above, continue to fill in the following birth weight. 2. Weight range of newborn: 100g-9999g. When the maternal primary diagnosis or other diagnostic codes contain Z37.0, Z37.2, Z37.3, Z37.5, Z37.6 codes, the birth weight of the newborn must be entered.Rehospitalization plan within 31 days after discharge or notB36CNumber1Threshold reference range RC028. Refers to the patient's rehospitalization arrangements within 31 days after the hospitalization and discharge. If there is a rehospitalization plan, you need to fill in the purpose, for example: performing a second operation.Purpose of 31-Day RehospitalizationB37Character100Required if rehospitalization plan within 31 days after discharge is Yes.Discharge wayB34CCharacter1Threshold reference range RC019；Refer to the way the patient was hospitalized and discharged, fill in the corresponding Arabic numbers.Total hospitalization feeD01Number(11,2)The total hospitalization fee is required and greater than 0; the total fee is greater than or equal to the sum of the sub-itemsSelf-paying fee in the total hospitalization feeD09Number(10,2)Less than or equal to total hospitalization fee1.Service fee of general medical treatmentD11Number(10,2)2.Operating fee of general medical treatmentD12Number(10,2)3.Nursing fee D13Number(10,2)4.Integrated Medical Services feeD14Number(10,2)5.Pathology diagnosis feeD15Number(10,2)6.Laboratory diagnosis feeD16Number(10,2)7.Fee of imaging diagnosis D17Number(10,2)8Clinical diagnosis feeD18Number(10,2)9Non-surgical treatment items feeD19Number(10,2)10.Surgery treatment feeD20Number(10,2)11Rehabilitation feeD21Number(10,2)12.Chinese medicine feeD22Number(10,2)13Western medicine feeD23Number(10,2)14.Chinese patent medicine feeD24Number(10,2)15Chinese herbal medicine feeD25Number(10,2)16.Blood feeD26Number(10,2)17.Albumin products feeD27Number(10,2)18.Globulin products feeD28Number(10,2)19. Blood clotting factors feeD29Number(10,2)20.Cytokines products feeD30Number(10,2)21Disposable medical materials for examination feeD31Number(10,2)22Disposable medical materials for treatment feeD32Number(10,2)23.Disposable medical materials for surgery feeD33Number(10,2)24.Other feesD34Number(10,2)2.2 Data element value field code2.2.1 RC001 Gender codeValueNameRemark00-Unknown sex11-Male22-Female99-Unspecified genderThis code comes from the national standard < Classification and codes of basic personal information> (GB/T 2261.1-2003)2.2.2 RC002 Marital status codeValueNameRemark11-Unmarried22-Married33-Widowed44-Divorced99-OtherThis code comes from the national standard <Classification and codes of basic personal information> (GB/T 2261.1-2003)2.2.3 RC003 Occupation code ValueNameRemark1111-National civil Servant1313-Professional and technical personnel1717-Staff2121-Corporate?executives2424-Workers2727-Farmers3131-Student3737-Serving?soldier5151-Freelance5454-Self-employed7070-Unemployed8080-Retired9090-OtherThis code comes from the national standard<Classification and codes of basic personal information>(GB/T2261.4)2.2.4 RC011 Medical record quality codeValueNameRemark11-AGood22-BGeneral33-CBad2.2.5 RC019 Discharge way codeValueName1Leave the hospital with a doctor's advice2Transfer with a doctor's advice3Transfer to community health service institutions/township health centers with a doctor's advice4Leave the hospital without a doctor's advice5Dead9Other2.2.6 RC023 Department code (<List of diagnosis and treatment subjects in medical institutions>)ValueName01Preventive Medicine Department02General Medicine Department03Internal Medicine Department0301Respiratory Department0302Gastroenterology Department0303Neurology Department0304Cardiology Department0305Hematology Department0306Nephrology Department0307Endocrinology Department0308Immunology Department0309Allergy Department0310Geriatric Department0311Other04Surgery 0401General Surgery040101Liver Transplantation040102Pancreatic Transplantation040103Small Bowel Transplantation 0402Neurological Surgery0403Orthopedics Department0404Urology Surgery040401Kidney Transplantation0405Thoracic Surgery040501Lung Transplantation0406Cardiac and Macrovascular Surgery040601Heart Transplantation0407Department of Burn0408Plastic Surgery0409Other05Obstetric and Gynecologic Department0501Gynecology Department0502Obstetrics Department0503Family Planning Department0504Eugenics Discipline Department0505Reproductive Health and Infertility Department0506 Other06Women's Health Care Department0601Adolescent Health Care Department0602Perinatal Health Care Department0603Climacteric Health Care Department0604Women's Mental Health Department0605Women's Nutrition Department0606Other07Pediatrics Department0701Neonatal Pediatrics Department0702Pediatric Infectious Diseases Department0703Pediatric Gastroenterology Department0704Pediatric Respiratory Department0705Pediatric Cardiology Department0706Pediatric Nephrology Department0707Pediatric Hematology Department0708Pediatric Neurology Department0709Pediatric Endocrinology Department0710Pediatric Genetic Diseases Department0711Pediatric Immunology Department0712Other08Pediatric Surgery 0801Pediatric General Surgery 0802Pediatric Orthopedics0803Pediatric Urology0804Pediatric Cardiothoracic Surgery0805Pediatric Neurological Surgery0806Other09Child Healthcare Department0901Child Growth & Development Department0902Child Nutrition Department0903Child Mental Health Department0904Facial Features and Health Care for Children Department0905Child Rehabilitation Department0906Other10Ophthalmology Department11Otolaryngology Department1101Otology Department1102Rhinology Department1103Pharyngology Department1104Other12Stomatology Department1201Stomatology Department1202Oral and Maxillofacial Surgery Department1203Orthodontic Department1204Prosthodontics Department1205Oral Preventive Health Department1206Other13Dermatology Department1301Dermatology Department1302Sexually Transmitted Diseases Department1303Other14Medical Cosmetology Department15Psychiatry Department1501Psychiatric Department1502Mental Health Department1503Drug Dependence Department1504Psychiatric Rehabilitation Department1505Community Prevention and Control Section Department1506Clinical Psychology Department1507Judicial Psychiatric Department1508Other16Infectious Diseases Department1601Intestinal Infectious Diseases Department1602Respiratory Infectious Diseases Department1603Hepatitis Department1604Insect-borne Infectious Diseases Department1605Animal Infectious Diseases Department1606Worm Diseases Department1607Other17Tuberculosis Department18Endemic Department19Oncology Department20Emergency Department21Rehabilitation Medicine Department22Sports Medicine Department23Occupational Disease Department2301Occupational Toxicology Department2302Pneumoconiosis Department2303Radiology Department2304Physical Factor Damage Department2305Occupational Health Care Unit2306Other24Hospice care Department25Special Medicine and Military Medicine Department26Anesthesiology Department27Pain Department28Critical Medicine Department30Medical Laboratory3001Clinical Humoral and Hematological Department3002Clinical Microbiology Department3003Clinical Biochemical Laboratory Department3004Clinical Immunology and Serology Department3005Clinical Cell and Molecular Genetics Department3006Other31Pathology Department32Medical Mm aging Department3201X-ray Diagnosis Department3202CT Diagnostic Department3203Magnetic Resonance Imaging Diagnosis Department3204Nuclear Medicine Department3205Ultrasonic Diagnosis Department3206ECG Laboratory3207EEG Laboratory3208Neuromuscular Electrography Laboratory3209Invasive Department and Medical Imagery3210Radiotherapy Department3211Other50Traditional Chinese Medicine Department5001Internal Medicine Department5002Surgery Department5003Maternity Department5004Pediatrics Department5005Dermatology Department5006Ophthalmology Department5007Otolaryngology Department5008Stomatology Department5009Oncology Department5010Orthopedics Department5011Proctology Department5012Geriatric Department5013Acupuncture and moxibustion Department5014Massage Department5015Rehabilitation Medicine Department5016Emergency Department5017Preventive Medicine Department5018Other51Ethnic Medicine Department5101Uygur Medicine Department5102Tibetan Medicine Department5103Mongolian Medicine Department5104Yi Medicine Department5105Dai Medicine Department5106Other52Integrated TCM & Western Medicine Department69Other Business Department 2.2.10 RC026 Admission way codeValueName11-Emergency22-Outpatient 33-Transfered from other medical institutions 99-Other2.2.7 RC027 Admission condition codeValueName11-Yes22-Clinically undetermined33-Unknown44-No2.2.8 RC028 Rehospitalization plan within 31 days after discharge codeValueName1No2Yes2.2.9 RC030 ABO blood group codeValueName1Type A2Type B3Type O4Type AB5Unknown6Not checked2.2.10 RC031 Rh blood group codeValueName1Negative2Positive3Unknown4Not checked2.2.11 RC032 Medical payment methods codeValueName1.11.1- UEBMI: The Urban Employee Basic Medical Insurance (local)1.21.2- UEBMI: The Urban Employee Basic Medical Insurance (externa)2.12.1- URBMI: The Rural Resident Basic Medical Insurance (local)2.22.2- URBMI: The Rural Resident Basic Medical Insurance (externa)3.13.1-NRCMI: The New Rural Cooperative Medical Insurance (local)3.23.2-NRCMI: The New Rural Cooperative Medical Insurance (externa)44-Poverty Relief55-Commercial Health Insurance66-All public health service77-Fully self-funded88-Other Social Insurance99-Other2.2.12 RC033 Contact relationship codeValueName00-Self or the head of household11-Spouse22-Son33-Daughter44-Grandchildren 55-Parents66-Grandparents 77-Brothers and sisters88-Colleagues and classmates99-OtherThis code refers to the national standard of "Family relationship Code" (GB/T4761)2.2.13 RC035 Ethnic Group codeValueName11-Han22-Mongolian33-Hui44-Tibetan55-Uygur66-Miao77-Yi88-Zhuang99-Buyei1010-Korean1111-Manchu1212-Dong1313-Yao1414-Bai1515-Tujia1616-Hani1717-Kazakh1818-Dai1919-Li2020-Lisu2121-Va2222-She2323-Gaoshan2424-Lahu2525-Shui2626-Dongxiang2727-Naxi2828-Jingpo2929-Kirgiz3030-Tu3131-Daur3232-Mulao3333-Qiang3434-Bulang3535-Salar3636-Maonan3737-Gelao3838-Xibe3939-Achang4040-Pumi4141-Tajik4242-Nu4343-Uzbek4444-Russ4545-Ewenki4646-De’ang4747-Baoan4848-Yugu4949-Jing5050-Tatar5151-Dulong5252-Oroqen5353-Hezhe5454-Mamba5555-Lhoba5656-Jinuo6666-Other9999-Foreign nationals2.2.14 RC036 Administrative divisionValueName11-Beijing22-Tianjin33-Hebei44-Shanxi55-Inner Mongolia66-Liaoning77-Jilin88-Heilongjiang99-Shanghai1010-Jiangsu1111-Zhejiang1212-Anhui1313-Fujian1414-Jiangxi1515-Shandong1616-Henan1717-Hubei1818-Hunan1919-Guangdong2020-Guangxi2121-Hainan2222-Sichuan2323-Chongqing2424-Guizhou2525-Yunnan2626-Tibet2727-Shaanxi2828-Gansu2929-Qinghai3030-Ningxia3131-Xinjiang3232-Taiwan3333-Hong Kong3434-Macau2.3.15 RC037 Drug allergyValueName11-Yes22-No3. Quality Control3.1 Basic rules of data quality controlData type should be compatible with interface standards;The data length does not exceed the maximum length specified by the interface standard;The data accuracy should be compatible with the interface standard. For example, if the length tag is "(10,2)", the length is 10 digits, and 2 decimal places are reserved;If the interface standard specifies threshold reference range, the data must be within the range;If the interface standard specifies a unit, the data must match the unit;If the data type is numeric, the data must be greater than or equal to 0 if it is not blank;The field names of the data collection items are consistent with the requirements of the interface standard;h) None of the "required" data can be blank or NULL. If there is no data or data is not applicable, fill in English dash "-". i) “Required depending on the conditions” is not a required term. When the condition is met, the data of the "required depending on the conditions" cannot be blank or NULL.3.2 Data Association Verification RulesVerification RulesVerification instructionsRelated parameter descriptionVerify age and date of birthAge equals admission time minus birthdate (the margin of error is 1 year)Admission time (B12)Date of birth (A13)Age (A14)Verify the relationship between admission time, discharge time and surgical operation timeAdmission time ≤ discharge time;(Admission time-1 day) ≤ surgical operation time ≤ discharge time;Admission time (B12)Discharge time (B15)primary surgical operation time (C16x01)other surgical operation time 1-40 (C37x01-C37x40)Verify diagnosis code rangeOutpatient (emergency) diagnosis code, primary and other discharge diagnosis code should be in the range of codes beginning with A to U and Z; excluding codes beginning with letters V, W, X, and YOutpatient (emergency) diagnosis code (C01C)primary discharge diagnosis code(C03C)other discharge diagnosis code 1-40 (C06x01C-C06x40C)Verify the diagnosis code for neonatal birth injury and neonatal age (change on May 8, 2019)When P10~P15 appears in the outpatient (emergency) diagnosis code, primary or other discharge diagnosis code, the admission time minus the date of birth must be less than 365 days, and the age (days) under 1 year old must be less than 365 daysOutpatient (emergency) diagnosis code(C01C)primary discharge diagnosis code (C03C)Other discharge diagnosis code 1-40 (C06x01C-C06x40C)Admission time (B12)Birthdate (A13)Age (days) under 1 year old (A16)Verify the integrity of the outcome coded by delivery and delivery (abortion)When O80-O84 appears in the primary or other discharge diagnosis code, and no O00-O08 appears in the abortive outcome code, the other discharge diagnosis code must have the delivery outcome code Z37primary discharge diagnosis code (C03C)Other discharge diagnosis code 1-40 (C06x01C-C06x40C)Verify the integrity of newborn birth weightWhen the primary or other discharge diagnosis code are Z37.0, Z37.2, Z37.3, Z37.5, Z37.6, or the age (days) under 1 year old is less than 28 days, or the admission time minus the birth date is less than or equal to 28 days, the birth weight of the newborn should not be blank.Newborn birth weight (A18x01)Primary discharge diagnosis code (C03C)Other discharge diagnosis code 1-40 (C06x01C-C06x40C)Age (days) under 1 year old (A16)Admission time (B12)Date of birth (A13)Verify the integrity of newborn admission weight When the age (days) under 1 year old ≤ 28 days, or admission time minus date of birth≤ 28 days, the neonatal admission weight should not be blank.Newborn admission weight (A17)Age (days) under 1 year old (A16)Admission time (B12)Date of birth (A13)Verify the integrity of age (days) under 1 year oldWhen the age is under 1 year old, that is, the age is 0, the age (days) under 1 year old should not be blank.Age (days) under 1 year old (A16)Age (A14)Verify the relationship between the total fee of hospitalization and the sum of sub-itemsThe total fee of hospitalization is required and greater than 0; the total fee of hospitalization is greater than or equal to the sum of the sub-itemsD01≥(D11+D12+D13+D14+D15+D16+D17+D18+D19+D20+D21+D22+D23+D24+D25+D26+D27+D28+D29+D30+D31+D32+D33+D34)；Total fee of hospitalization (D11)General treatment operation fee (D12)Nursing fee (D13)Other fee for Comprehensive Medical Services (D14)Pathological diagnosis fee (D15)Laboratory diagnosis fee (D16)Imaging diagnosis fee (D17)Clinical diagnosis item fee (D18)Non-surgical treatment item fee (D19)Surgical treatment fee (D20)Rehabilitation fee (D21)Chinese medicine treatment fee (D22)Western medicine fee (D23)Chinese patent medicine fee (D24)Chinese herbal medicine fee (D25)Blood fee (D26)Albumin products fee(D27)Globulin products fee(D28)Clotting factor products fee(D29)Cytokine products fee(D30)Disposable inspection medical supply fee(D31)Disposable treatment medical supply fee(D32)Disposable surgery medical supply fee(D33)Other fees (D34)Verify the relationship between total hospital fee and self-paying fee from total hospitalization feeThe total hospitalization fee must be greater than or equal to self-paying fee out of total hospitalization fee D01≥D09Total hospitalization fee(D01)self-paying fee out of total hospitalization fee (D09)Verify the relationship between nonsurgical treatment item fee, clinical physiotherapy feeThe nonsurgical treatment item fee must be greater than or equal to the clinical physiotherapy fee D19≥D19x01Nonsurgical treatment item fee (D19)Clinical physiotherapy fee (D19x01)Verify the relationship between surgical treatment fee, anesthesia fee and surgery feeThe surgical treatment fee must be greater than or equal to the sum of anesthesia fee and surgery fee D20≥(D20x01+D20x02)Surgical treatment fee (D20)Anesthesia fee (D20x01)Surgery fee (D20x02)Verify the relationship between western medicine fee and antibacterial drug feeThe western medicine fee must be greater than or equal to the antibacterial drug feeD23≥D23x01Western medicine fee (D23)Antibacterial drug fee (D23x01)Verify the quality control (QC) date rangeThe QC date cannot be earlier than the admission timeQC date (B33)Admission time (B12)Verify the history of drug allergies and names of allergic drugsIf there is a drug allergy, the name of the allergic drug is required.drug allergy or not(C24C) 2=yesName of the allergic drug (C25)Verify the relationship between discharge way and name of the doctor's order to transfer to other hospitals or the community health service/ township hospitalsThe discharge way is required for patients transferred by doctor's order to other hospitals or community health service / township hospitals.Discharge way (B34C) 2= (transferred by doctor's order to other hospitals), 3= (transferred by doctor's order to community health service / township hospitals)Name of the doctor's order to transfer to other hospitals or the community health service/ township hospitals (B35)Verify the relationship between whether there is a readmission plan within 31 days after discharge or not and the purpose of the 31-day hospital readmission planIf there is a readmission plan within 31 days after discharge, the purpose of 31-day hospital readmission is required.readmission plan within 31 days after discharge or not (B36C) 2=yesPurpose of 31-day hospital readmission (B37)Verify the relationship between the primary discharge diagnosis code and the pathological diagnosis code, pathological diagnosis name and pathology number at dischargeRequired for cancer patients. When the initial letter of the primary discharge diagnosis code is C or D00-D10 or D45-D47, the pathological diagnosis code, pathological diagnosis name and pathology number should not be empty.Primary discharge diagnosis code (C03C)Pathological diagnosis code (C09C)Pathological diagnosis name (C10N)Pathology number (C11)Verify the relationship between primary discharge diagnosis code and both the code and name of external causes of injury and poisoningRequired for patients with poisoning; when the initial letter of the primary discharge diagnosis code is S or T, the code and name of external causes of the injury and poisoning should not be empty.The primary discharge diagnosis code (C03C)Code of external causes of the injury and poisoning (C12C)Name of external causes of the injury and poisoning name (C13N)Verify the ID numberThe ID card number needs to comply with the provisions of the National Standard GB 11643-1999 of the People's Republic of China on citizenship number.ID card number (A20)Section 2 Analysis protocol1. Basic Requirements Accord to "field definition" in section 2 HQMS interface standard and "value threshold range" in its notes.1.1 Search time range According to the time of discharge (B5): 2016.1.1-2018.12.31.1.2 Analysis related keywords Neuromyelitis optical spectrum disorder (NMOSD).1.3 New variable generated from the previous criterionNew variableFormulaMeaning and thresholdC03CC03CPrimary diagnosis code: National Classification 2.0 Disease Diagnosis Code (ICD-10)C06The collection of these 40 variables from C06x01C toC06x40CAll other diagnoses：the value threshold is the disease ICD-10 code (composed of a letter and a string of numbers)1.4 Specification of results required Mean ± standard deviation, 95% CI, median± IQR, P50 (P25, P75).2. Identify the Study Population2.1 Search criteria: primary diagnosis code (C03C) or other discharge diagnosis code (C06x01C-C06x40C).2.2 Newly generated variables Diagnosis code refers to international Classification of Diseases, Tenth revision (ICD-10) code (China National Edition 2.0).New variableICD-10 codeMeaning uIDDG37.5 or G37.8 or G37.9 or G04.800Unclassed idiopathic central nervous system demyelinating diseaseADEMG36.801 or G04.001 Acute disseminated encephalomyelitisATMG36.901 or G37.300 or G04.902 or G04.909 or G04.910Acute MyelitisONH46Optic neuritisMSG35.0Multiple sclerosisNMOSD G36.000Neuromyelitis optica [Devic]G36.000x002Neuromyelitis optica Spectrum disorderCISG37.805Clinical isolated syndrome2.3 The same person definition: Generate new variables based on name, age, and ID.3.Steps of Analysis in NMOSD3.1 Data source descriptionNumber of hospitals reported by provinces showing the number of hospitals related to the total study populationProvinceNumber of HQMS hospitals reportedNumber of consecutively reported hospitalsAnhui…Nationwide3.2 Number of new diagnoses per year for NMOSDSearch condition:Discharge diagnosis: C03C=NMOSDGeographical distribution: organization code (A01), birth address (A22), province of origin (A23C), and residence address (A24)Newly diagnosed cases are defined as patients who are first recorded in the HQMS database and primarily diagnosed with NMOSD.Result output: Number of new diagnoses of NMOSD per year by province and country.3.3 Discharge department distribution of NMOSDSearch condition:Discharge diagnosis: C03C or C06=NMOSDDischarge department: Discharge department (B16C) Results output: Distribution of discharge departments of NMOSD from 2016 to 20183.4 Age and gender distribution of patients with NMOSDSearch condition: Discharge diagnosis: C03C or C06=NMOSD.Variables: age (A14), gender (A12C).Results output: age and sex distribution of NMOSD from 2016 to 2018.3.5 Changes in medical care payment methodsSearch condition: Discharge diagnosisC03C or C06=NMOSDVariables: Medical payment method (A46C).Results output: Changes in medical care payment methods of NMOSD from 2016 to 2018.3.6 Changes in hospitalization costsSearch condition: Discharge diagnosis: C03C or C06=NMOSDVariables: hospitalization expenses including total hospitalization expenses, self-pay amount in total hospitalization expenses, nursing fees, imaging diagnosis fees, laboratory diagnosis fees, rehabilitation costs, western medicine costs, proprietary Chinese medicine costs.Definition of annual hospitalization cost: number of patients per year= number of discharges-number of repeated discharges; annual average cost = annual total hospitalization cost / number of patientsResults output: Cost of hospitalization for NMOSD from 2016 to 20183.7 Change in length of hospitalization stay Search condition: Discharge diagnosis: C03C or C06=NMOSDVariables: actual number of days in hospital (B20). Definition of average length of stay. Number of Patients = Number of Discharges-Number of Repeat Discharges; Average Hospitalization Day = Length of Hospitalization / Number of PatientResults output: length of hospitalization stay of NMOSD from 2016 to 2018.3.8 Analysis of Co-existing diseaseSearch condition: Discharge diagnosis: C03C or C06=NMOSDVariables: Comorbidities (see in the below table).Disease nameICD-10 codeHypertensionI10, I12, I13DiabetesE10, E11, I13, I14OsteoporosisM80-M81DyslipidemiaE78.0-E78.5Cerebral infarctionI63Intracerebral hemorrhageI61Malignant tumorC00-C97ArthritisM05, M09Autoimmune diseaseM30-M35Behcet's diseaseM35.2Sj?gren's syndromeM35.0Systemic lupus erythematosusM32AnxietyF41DepressionF32Results output: Comorbidities of NMOSD from 2016 to 2018 nationwide.3.9 Analysis of deathsSearch condition:Discharge diagnosis: C03C or C06=NMOSD.Variables: Death (B34C); gender (A12C); age (A14); discharge department (B16C), cause of death.Results output: Analysis deaths of National NMOSD from 2016 to 2018 nationwide. Reference ADDIN EN.REFLIST 1.Jiang L, Krumholz HM, Li X, Li J, Hu S. Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system. Lancet 2015; 386(10002): 1493-505.2.Lin Y, Yang C, Chu H, et al. Association between the Charlson Comorbidity Index and the risk of 30-day unplanned readmission in patients receiving maintenance dialysis. BMC nephrology 2019; 20(1): 363.3.Han X, Zhou H. Monitoring traumatic brain injury in China. The Lancet Neurology 2019; 18(9): 813.4.Yang C, Wang H, Zhao X, et al. CKD in China: Evolving Spectrum and Public Health Implications. American journal of kidney diseases : the official journal of the National Kidney Foundation 2019.Appendix Table 1 The number of tertiary hospitals involved in each province in this study.ProvinceNumber of HospitalPercentage（%）Cumulative frequencyCumulative percentage（%）Anhui452.7452.7Beijing513.06965.77Chongqing251.51217.27Fujian472.8216810.09Gansu271.6219511.71Guangdong1368.1733119.88Guangxi563.3638723.24Guizhou422.5242925.77Hainan181.0844726.85Hebei492.9449629.79Heilongjiang603.655633.39Henan684.0862437.48Hubei744.4469841.92Hunan623.7276045.65Inner Mongolia442.6480448.29Jiangsu1056.3190954.59Jiangxi513.0696057.66Jilin311.8699159.52Liaoning855.11107664.62Ningxia90.54108565.17Qinghai130.78109865.95Shaanxi472.82114568.77Shandong955.71124074.47Shanghai352.1127576.58Shanxi442.64131979.22Sichuan1448.65146387.87Tianjin301.8149389.67Tibet70.42150090.09Xinjiang422.52154292.61Yunnan321.92157494.53Zhejiang915.471665100Appendix Figure 1: The geographical distribution of 1665 tertiary hospitals in this study. The study was conducted in mainland China. Hong Kong and Macao were not included. ................
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