Validity of ICD-10-CM codes for determination of diabetes type for persons with youth-onset type 1 and type 2 diabetes
Validity of ICD-10-CM codes for determination of diabetes type for persons with youth-onset type 1 and type 2 diabetes
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DOI：
10.1136/bmjdrc-2018-000547
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发表时间：
2019-06-01
影响因子：
4.1
通讯作者：
Lawrence, Jean M.
中科院分区：
文献类型：
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作者：
Chi, Gloria C.;Li, Xia;Lawrence, Jean M.
目的诊断码若能准确区分糖尿病类型，可用于糖尿病监测。我们评估了国际疾病分类第十版临床修改（ICD-10-CM）代码在年轻发病（诊断年龄= 50%）的健康计划成员中区分1型糖尿病（T1DM）和2型糖尿病（T2DM）的有效性，T2DM编码遭遇被归类为T2DM。否则，这些人被归类为T1DM。我们计算了敏感性、特异性、阳性和阴性预测值以及总体和人口统计学特征的准确性。结果T1DM 1911例，T2DM 652例，平均年龄（SD）： 19.1（6.5）岁。我们获得了90.6% （95% CI 88.4% ~ 92.9%）的敏感性，96.3% （95% CI 95.4% ~ 97.1%）的特异性，89.3% （95% CI 86.9% ~ 91.6%）的阳性预测值，96.8% （95% CI 96.0% ~ 97.6%）的阴性预测值，以及94.8% （95% CI 94.0% ~ 95.7%）的T2DM和T1DM鉴别准确率。结论ICD-10-CM代码可以准确地对青年发病糖尿病患者进行糖尿病类型分类，有望实现快速、经济有效的糖尿病监测。
Objective Diagnosis codes might be used for diabetes surveillance if they accurately distinguish diabetes type. We assessed the validity of International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes to discriminate between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) among health plan members with youth-onset (diagnosis age = 50% T2DM-coded encounters were classified as having T2DM. Otherwise, persons were classified as having T1DM. We calculated sensitivity, specificity, positive and negative predictive values, and accuracy overall and by demographic characteristics.Results According to the gold standard, 1911 persons had T1DM and 652 persons had T2DM (mean age (SD): 19.1 (6.5) years). We obtained 90.6% (95% CI 88.4% to 92.9%) sensitivity, 96.3% (95% CI 95.4% to 97.1%) specificity, 89.3% (95% CI 86.9% to 91.6%) positive predictive value, 96.8% (95% CI 96.0% to 97.6%) negative predictive value, and 94.8% (95% CI 94.0% to 95.7%) accuracy for discriminating T2DM from T1DM.Conclusions ICD-10-CM codes can accurately classify diabetes type for persons with youth-onset diabetes, showing promise for rapid, cost-efficient diabetes surveillance.