International Classification of Diseases, 9th Revision, Clinical Modification codes in discharge abstracts are poor measures of complication occurrence in medical inpatients
International Classification of Diseases, 9th Revision, Clinical Modification codes in discharge abstracts are poor measures of complication occurrence in medical inpatients
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DOI：
10.1097/00005650-199706000-00005
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发表时间：
1997-06-01
期刊：
影响因子：
3
通讯作者：
Wu, L
中科院分区：
文献类型：
--
作者：
Geraci, JM;Ashton, CM;Wu, L
目标。作者使用通过图表审查确定的并发症作为金标准，测试了出院摘要中的国际疾病分类第 9 版临床修改 (ICD-9-CM) 代码识别经历院内并发症的住院患者的能力。方法。使用了两套 ICD-9-CM 代码：一套包括许多医疗诊断，这些医疗诊断也可能是入院时共存的并发症而不是并发症；另一套主要由 ICD-9-CM 特定的并发症和药物不良事件代码组成。结果。根据接受者操作特征分析，这两组都不能很好地作为并发症发生的诊断测试（包含组的 ROC 面积为 0.61，排除组的 ROC 面积为 0.55）。 ICD-9-CM 代码对并发症的敏感性对于包含组为 0.34，对于排除组为 0.14。相应的阳性预测值分别为0.32和0.37。代码定义对个别并发症的敏感性普遍较差，大多数情况下小于 0.5。结论。作者得出的结论是，出院摘要中的 ICD-9-CM 代码不能很好地衡量并发症的发生情况。
OBJECTIVES. The authors tested the ability of international Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes in discharge abstracts to identify medical inpatients who experienced an in-hospital complication, using complications identified through chart review as the gold standard.METHODS. TWO sets of ICD-9-CM codes were used: an inclusive set including many medical diagnoses that may also be coexistent complicating conditions on admission rather than complications and an exclusive set consisting primarily of ICD-9-CM-specified complication and adverse drug event codes.RESULTS. Neither set performed well as a diagnostic test for complication occurrence according to receiver operating characteristic analysis (ROC areas were 0.61 for the inclusive set and 0.55 for the exclusive set). Sensitivities of the ICD-9-CM codes for complications were 0.34 for the inclusive set and 0.14 for the exclusive set. Corresponding positive predictive values were 0.32 and 0.37, respectively. Sensitivities of code definitions for individual complications were generally poor, less than 0.5 in most cases.CONCLUSIONS. The authors conclude that ICD-9-CM codes in discharge abstracts are poor measures of complication occurrence.