Administrative data have high variation in validity for recording heart failure
Administrative data have high variation in validity for recording heart failure
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DOI：
10.1016/s0828-282x(10)70438-4
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发表时间：
2010-10-01
影响因子：
6.2
通讯作者：
Quan, Hude
中科院分区：
文献类型：
--
作者：
Quach, Susan;Blais, Claudia;Quan, Hude
背景：许多研究依赖于管理数据来识别心力衰竭(HF)患者。目的：系统回顾评估管理数据用于记录心力衰竭(HF)的有效性的研究。方法：纳入1990年至2008年的英文同行评议文章，从管理数据中验证国际疾病分类(ICD)-8、-9和-10代码。一个专家小组决定应该包括哪些ICD代码来定义HF。在2000/2001和2005/2006财政年度，使用加拿大医院出院摘要中提供的多达16个诊断编码字段来计算用于定义HF的ICD代码的频率。结果：在1992至2008年间，在25项已发表的研究中使用了70多种不同的ICD代码来定义HF。21项研究证实了出院摘要数据；3项研究证实了医生的说法，两项研究证实了门诊护理数据。18项研究报告了敏感性(范围为29%至89%)。在17项研究中，特异度和阴性预测值均大于70%。19项研究报告了阳性预测值(范围从12%到100%)。有10项研究报告了卡伯值(范围在0.39到0.84之间)。对于加拿大医院出院数据，ICD-9和-10代码428和I50分别在5.50%和4.80%的出院记录中识别出HF。结论：ICD-9和-10编码428和I50是医院出院数据中最常用的定义HF的编码。管理数据在记录心力衰竭方面的有效性在评估的研究和数据来源中各不相同。
BACKGROUND: Many studies have relied on administrative data to identify patients with heart failure (HF).OBJECTIVE: To systematically review studies that assessed the validity of administrative data for recording HF.METHODS: English peer-reviewed articles (1990 to 2008) validating International Classification of Diseases (ICD)-8, -9 and -10 codes from administrative data were included. An expert panel determined which ICD codes should be included to define HF. Frequencies of ICD codes for HF were calculated using up to the 16 diagnostic coding fields available in the Canadian hospital discharge abstract during fiscal years 2000/2001 and 2005/2006.RESULTS: Between 1992 and 2008, more than 70 different ICD codes for defining HF were used in 25 published studies. Twenty-one studies validated hospital discharge abstract data; three studies validated physician claims and two studies validated ambulatory care data. Eighteen studies reported sensitivity (range 29% to 89%). Specificity and negative predictive value were greater than 70% across 17 studies. Nineteen studies reported positive predictive values (range 12% to 100%). Ten studies reported kappa values (range 0.39 to 0.84). For Canadian hospital discharge data, ICD-9 and -10 codes 428 and I50 identified HF in 5.50% and 4.80% of discharge records, respectively. Additional HF-related ICD-9 and -10 codes did not impact HF prevalence.CONCLUSION: The ICD-9 and -10 codes 428 and I50 were the most commonly used to define HF in hospital discharge data. Validity of administrative data in recording HF varied across the studies and data sources that were assessed.