The validity of ICD codes coupled with imaging procedure codes for identifying acute venous thromboembolism using administrative data
The validity of ICD codes coupled with imaging procedure codes for identifying acute venous thromboembolism using administrative data
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DOI：
10.1177/1358863x15573839
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发表时间：
2015-08-01
影响因子：
3.5
通讯作者：
McMurtry, M. Sean
中科院分区：
文献类型：
--
作者：
Alotaibi, Ghazi S.;Wu, Cynthia;McMurtry, M. Sean
本研究的目的是评价联合使用国际疾病分类（ICD）诊断代码和成像程序代码在管理数据库中识别深静脉血栓形成（DVT）和肺栓塞（PE）的准确性。从加拿大阿尔伯塔的阿尔伯塔卫生部（AH）住院患者和门诊护理管理数据库中获得了2000年至2010年期间在阿尔伯塔的一家大型教学医院进行的记录影像学研究结果的受试者的信息，以排除静脉血栓栓塞（VTE）。在1361例随机选择的患者中，使用ICD诊断代码和手术代码，以病历中记录的诊断作为金标准，确定了通过AH管理数据正确分类的DVT和PE患者比例。在1361名患者中，712名疑似PE，649名疑似DVT。使用管理数据识别PE或DVT患者的灵敏度分别为74.83%（95%置信区间[CI]：67.01-81.62）和75.24%（95% CI：65.86-83.14）。PE和DVT的特异性分别为91.86%（95%CI：89.29-93.98）和95.77%（95%CI：93.72-97.30）。总之，当与相关的成像代码相结合时，从管理数据中获得的VTE诊断代码提供了一种相对敏感且非常特异的方法来确定急性VTE。
The purpose of this study was to evaluate the accuracy of using a combination of International Classification of Diseases (ICD) diagnostic codes and imaging procedure codes for identifying deep vein thrombosis (DVT) and pulmonary embolism (PE) within administrative databases. Information from the Alberta Health (AH) inpatients and ambulatory care administrative databases in Alberta, Canada was obtained for subjects with a documented imaging study result performed at a large teaching hospital in Alberta to exclude venous thromboembolism (VTE) between 2000 and 2010. In 1361 randomly-selected patients, the proportion of patients correctly classified by AH administrative data, using both ICD diagnostic codes and procedure codes, was determined for DVT and PE using diagnoses documented in patient charts as the gold standard. Of the 1361 patients, 712 had suspected PE and 649 had suspected DVT. The sensitivities for identifying patients with PE or DVT using administrative data were 74.83% (95% confidence interval [CI]: 67.01-81.62) and 75.24% (95% CI: 65.86-83.14), respectively. The specificities for PE or DVT were 91.86% (95% CI: 89.29-93.98) and 95.77% (95% CI: 93.72-97.30), respectively. In conclusion, when coupled with relevant imaging codes, VTE diagnostic codes obtained from administrative data provide a relatively sensitive and very specific method to ascertain acute VTE.