Validation of Case Identification for Alopecia Areata Using International Classification of Diseases Coding.
Validation of Case Identification for Alopecia Areata Using International Classification of Diseases Coding.
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DOI：
10.4103/ijt.ijt_67_20
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发表时间：
2020-09
影响因子：
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通讯作者：
Mostaghimi A
中科院分区：
文献类型：
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作者：
Lavian J;Li SJ;Lee EY;Bordone LA;Polubriaginof FCG;Christiano AM;Mostaghimi A
用于识别斑秃（AA）患者的搜索算法需要在大型数据库中使用之前进行验证。这项研究的目的是评估患有疾病和相关健康问题国际统计分类（ICD）9或10编码AA的患者是否真正诊断为AA。在哥伦比亚大学欧文医学中心、布里格姆妇女医院和马萨诸塞州总医院进行了一项多中心回顾性审查，以确定患者是否具有ICD 9代码（704.01 - AA）或ICD 10代码AA（L63.0 -全秃、L63.1 -普秃、L63.2 -蛇癖、L63.8 -其他AA和L63.9 - AA，未指明）符合疾病的诊断标准。在880张图表中，97.5%的体检结果与AA一致，90%的诊断明确。在87%的图表中，皮肤科医生诊断出AA。ICD 9编码704.01的阳性预测值（PPV）为97%（248/255）。ICD 10代码的PPV分别为：L63.0 64%（75/118）、L63.1 86%（130/151）、L63.2 50%（1/2）、L63.8 91%（81/89）和L63.9 93%（247/265）。总体而言，89%（782/880）的ICD编码为AA的患者被认为具有AA的真实诊断。医疗记录中包含AA相关ICD代码的患者有很高的患病概率。
Search algorithms used to identify patients with alopecia areata (AA) need to be validated prior to use in large databases. The aim of the study is to assess whether patients with an International Statistical Classification of Diseases and Related Health Problems (ICD) 9 or 10 code for AA have a true diagnosis of AA. A multicenter retrospective review was performed at Columbia University Irving Medical Center, Brigham and Women's Hospital, and Massachusetts General Hospital to determine whether patients with an ICD 9 codes (704.01 - AA) or ICD 10 codes (L63.0 -Alopecia Totalis, L63.1 - Alopecia Universalis, L63.2 - Ophiasis, L63.8 - other AA, and L63.9 - AA, unspecified) for AA met diagnostic criteria for the disease. Of 880 charts, 97.5% had physical examination findings consistent with AA, and 90% had an unequivocal diagnosis. AA was diagnosed by a dermatologist in 87% of the charts. The positive predictive value (PPV) of the ICD 9 code 704.01 was 97% (248/255). The PPV for the ICD 10 codes were 64% (75/118) for L63.0, 86% (130/151) for L63.1, 50% (1/2) for L63.2, 91% (81/89) for L63.8, and 93% (247/265) for L63.9. Overall, 89% (782/880) of patients with an ICD code for AA were deemed to have a true diagnosis of AA. Patients whose medical records contain an AA-associated ICD code have a high probability of having the condition.