Assessment of the Accuracy of Identification of Selected Disabilities and Conditions in Hospital Discharge Data for Pregnant Women.
Assessment of the Accuracy of Identification of Selected Disabilities and Conditions in Hospital Discharge Data for Pregnant Women.
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DOI：
10.1097/ede.0000000000001185
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发表时间：
2020-09
期刊：
影响因子：
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通讯作者：
Mueller BA
中科院分区：
文献类型：
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作者：
Schwartz NRM;Crane DA;Doody DR;Schiff MA;Mueller BA
将出生证明与出院记录相联系是检查残疾妇女怀孕结果的宝贵资源。依靠这些数据进行的研究很少能够评估识别先前存在的残疾状况的准确性。我们评估了国际疾病分类第9版（ICD 9）编码的准确性，以确定可能导致残疾的选定身体，感官和智力条件。由于ICD 9编码直到最近才在大多数州使用，因此该信息有助于为这些记录的分析提供信息。我们回顾了311例（90%）基于ICD 9编码的残疾孕妇病历中的280例，以及8，337例（5%）在大型大学医疗中心分娩的非残疾孕妇病历中的390例。我们以病历为金标准，估计敏感性、特异性和阳性预测值（PPV）。我们使用逆概率加权和插补调整验证偏倚。2009-2012年，ICD 9编码识别分娩残疾妇女的敏感度估计为44%; PPV为98%，随着时间的推移有所改善。尽管某些情况下的敏感性<50%，但除智力残疾（67%）外，所有情况下的PPV均为87%-100%。许多身体状况都得到了完整的核实，没有漏报。这些结果有助于新的研究，使用历史数据比较有和没有这些条件的妇女的结果，并为早期研究结果的解释提供信息。有必要评估ICD第10版代码所确定的残疾的准确性。
Linked birth certificate–hospital discharge records are a valuable resource for examining pregnancy outcomes among women with disability conditions. Few studies relying on these data have been able to assess the accuracy of identification of pre-existing disability conditions. We assessed the accuracy of International Classification of Diseases version 9 (ICD9) codes for identifying selected physical, sensory, and intellectual conditions that may result in disability. As ICD9 codes were utilized until recently in most states, this information is useful to inform analyses with these records. We reviewed 280 of 311 (90%) medical records of pregnant women with disabilities based on ICD9 codes and 390 of 8,337 (5%) records of pregnant women without disabilities who had deliveries at a large university medical center. We estimated sensitivity, specificity, and positive predictive values (PPV) using the medical record as gold standard. We adjusted for verification bias using inverse probability weighting and imputation. The estimated sensitivity of ICD9 codes to identify women with disabilities with deliveries 2009–2012 was 44%; PPV was 98%, improving over time. Although sensitivity was <50% for some conditions, PPVs were 87%−100% for all conditions except intellectual disability (67%). Many physical conditions had complete verification and no underreporting. These results are helpful for new studies using historical data comparing outcomes among women with and without these conditions, and to inform interpretation of results from earlier studies. Assessment of the accuracy of disabilities as identified by ICD version 10 codes is warranted.