Coding algorithms for identifying patients with cirrhosis and hepatitis B or C virus using administrative data
Coding algorithms for identifying patients with cirrhosis and hepatitis B or C virus using administrative data
复制标题
DOI：
10.1002/pds.3721
复制
发表时间：
2015-01-01
影响因子：
2.6
通讯作者：
Goldberg, David S.
中科院分区：
文献类型：
--
作者：
Niu, Bolin;Forde, Kimberly A.;Goldberg, David S.
背景和目的尽管使用管理数据对乙型或丙型肝炎病毒（HBV， HCV）患者进行流行病学和成本效益研究，但除了退伍军人健康管理局之外，没有数据验证国际疾病分类第九次修订临床修改（ICD-9-CM）代码是否可以准确识别肝硬化HBV或HCV患者。对这些算法的验证对于未来的流行病学研究是必要的。方法：我们评估了ICD-9-CM代码在宾州大学卫生系统中识别肝硬化患者中慢性HBV或HCV的阳性预测价值（PPV），该系统是一个大型网络，包括三级保健转诊中心、社区医院和宾夕法尼亚州东南部和新泽西州南部的多个门诊诊所。我们随机调查了200名携带ICD-9-CM编码的HCV患者和150名携带ICD-9-CM编码的HBV患者。结果1例住院患者或2例门诊患者HCV编码的PPV为88.0% (168/191,95% CI: 82.5 ~ 92.2%)， 1例住院患者或2例门诊患者HBV编码的PPV为81.3% （113/139,95% CI: 73.8 ~ 87.4%）。评估了几种主要编码算法的变化，以确定住院和/或门诊ICD-9-CM编码的不同组合是否可以增加编码算法的PPV。结论sicd -9- cm编码可以识别高PPV肝硬化患者的慢性HBV或HCV，可用于未来的流行病学研究，以检查疾病负担和资源的合理分配。版权所有：John Wiley & Sons， Ltd。
Background and aimsDespite the use of administrative data to perform epidemiological and cost-effectiveness research on patients with hepatitis B or C virus (HBV, HCV), there are no data outside of the Veterans Health Administration validating whether International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes can accurately identify cirrhotic patients with HBV or HCV. The validation of such algorithms is necessary for future epidemiological studies.MethodsWe evaluated the positive predictive value (PPV) of ICD-9-CM codes for identifying chronic HBV or HCV among cirrhotic patients within the University of Pennsylvania Health System, a large network that includes a tertiary care referral center, a community-based hospital, and multiple outpatient practices across southeastern Pennsylvania and southern New Jersey. We reviewed a random sample of 200 cirrhotic patients with ICD-9-CM codes for HCV and 150 cirrhotic patients with ICD-9-CM codes for HBV.ResultsThe PPV of 1 inpatient or 2 outpatient HCV codes was 88.0% (168/191, 95% CI: 82.5-92.2%), while the PPV of 1 inpatient or 2 outpatient HBV codes was 81.3% (113/139, 95% CI: 73.8-87.4%). Several variations of the primary coding algorithm were evaluated to determine if different combinations of inpatient and/or outpatient ICD-9-CM codes could increase the PPV of the coding algorithm.ConclusionsICD-9-CM codes can identify chronic HBV or HCV in cirrhotic patients with a high PPV and can be used in future epidemiologic studies to examine disease burden and the proper allocation of resources. Copyright (c) 2014 John Wiley & Sons, Ltd.