The importance of nomenclature for congenital cardiac disease: implications for research and evaluation.
The importance of nomenclature for congenital cardiac disease: implications for research and evaluation.
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DOI：
10.1017/s1047951108002515
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发表时间：
2008-12
影响因子：
1
通讯作者：
Correa A
中科院分区：
文献类型：
--
作者：
Strickland MJ;Riehle-Colarusso TJ;Jacobs JP;Reller MD;Mahle WT;Botto LD;Tolbert PE;Jacobs ML;Lacour-Gayet FG;Tchervenkov CI;Mavroudis C;Correa A
管理数据库通常用于先天性心脏病研究和评估，很少验证诊断代码的准确性。使用国际儿科和先天性心脏代码版本对亚特兰大大都会先天性缺陷计划监测记录进行审查和分类。使用该临床命名法作为参考，我们报告了国际疾病分类第九版修订版、法洛四联症、大动脉转位和左心发育不良综合征临床修改诊断代码的敏感性和假阳性分数（1 - 阳性预测值）。我们从监测记录中发现了 4918 名患有先天性心脏病的婴儿和胎儿。仅使用国际疾病分类诊断代码，四联症记录为 280 条，转位记录为 317 条，左心发育不全综合征记录为 192 条。根据国际儿科和先天性心脏病规范，有 330 条记录被归类为四联症，163 条记录被归类为转位，179 条记录被归类为左心发育不全综合征。国际疾病分类诊断代码对四联症的敏感性为 83%，对转位的敏感性为 100%，对左心发育不全综合征的敏感性为 95%。四联症的假阳性率为 2%，转位的假阳性率为 49%，左心发育不全综合征的假阳性率为 11%。基于国际疾病分类诊断代码的分析可能存在严重的先天性心脏病分类错误。分离主要缺陷很困难，并且某些代码无法区分临床和发育不同的变体。
Administrative databases are often used for congenital heart disease research and evaluation, with little validation of the accuracy of the diagnostic codes. Metropolitan Atlanta Congenital Defects Program surveillance records were reviewed and classified using a version of the International Pediatric and Congenital Cardiac Code. Using this clinical nomenclature as the referent, we report the sensitivity and false positive fraction (1 – positive predictive value) of the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for tetralogy of Fallot, transposition of the great arteries, and hypoplastic left heart syndrome. We identified 4918 infants and foetuses with congenital heart disease from the surveillance records. Using only the International Classification of Diseases diagnosis codes, there were 280 records with tetralogy, 317 records with transposition, and 192 records with hypoplastic left heart syndrome. Based on the International Pediatric and Congenital Cardiac Code, 330 records were classified as tetralogy, 163 records as transposition, and 179 records as hypoplastic left heart syndrome. The sensitivity of International Classification of Diseases diagnosis codes was 83% for tetralogy, 100% for transposition, and 95% for hypoplastic left heart syndrome. The false positive fraction was 2% for tetralogy, 49% for transposition, and 11% for hypoplastic left heart syndrome. Analyses based on International Classification of Diseases diagnosis codes may have substantial misclassification of congenital heart disease. Isolating the major defect is difficult, and certain codes do not differentiate between variants that are clinically and developmentally different.