Identification of patients with diabetic macular edema from claims data - A validation study
Identification of patients with diabetic macular edema from claims data - A validation study
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DOI：
10.1001/archopht.126.7.986
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发表时间：
2008-07-01
影响因子：
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通讯作者：
Lee, Paul P.
中科院分区：
文献类型：
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作者：
Bearelly, Srilaxmi;Mruthyunjaya, Prithvi;Lee, Paul P.
目的：评估使用国际疾病分类第九版临床修订版识别糖尿病黄斑水肿（DME）患者的算法的有效性（ICD-9-CM）诊断代码在行政帐单数据从一个方便的样本医生办公室。12名普通眼科医生和10名视网膜专家的便利样本应用了基于ICD-9的预先指定的算法，CM诊断代码，以计费索赔的做法，并选择了相关的医疗记录。四位眼科医生从病历中提取数据，然后与编码诊断进行比较。主要结果指标的敏感性，特异性，和K统计的DME算法（代码250.XX和362.53的组合），治疗DME的医疗记录文件作为标准criterion.Results：DME算法的敏感性为0.88，特异性为0.96识别DME。算法与病历之间的一致性非常好（kappa = 0.84）。该算法在识别具有临床意义的DME诊断患者方面表现不佳（灵敏度，0.86;特异性，0.84; Kappa = 0.64）。结论：该初步研究的结果表明，DME患者可以准确地识别使用ICD-9-CM诊断代码的索赔数据。该算法的应用可以改善疾病患病率和疾病负担的调查，并提供一种有效的手段，评估护理和干预措施。
Objective: To assess the validity of an algorithm for identifying patients with diabetic macular edema (DME) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes in administrative billing data from a convenience sample of physician offices.Methods: A convenience sample of 12 general ophthalmologists and 10 retina specialists applied prespecified algorithms based on ICD-9-CM diagnosis codes to the billing claims of their practices and selected the associated medical records. Four ophthalmologists abstracted data from the medical records, which were then compared with the coded diagnoses. Main outcome measures were sensitivity, specificity, and the K statistic for the DME algorithm (a combination of codes 250.xx and 362.53), treating medical record documentation of DME as the standard criterion.Results: The DME algorithm had a sensitivity of 0.88 and a specificity of 0.96 for identifying DME. Excellent agreement was noted between the algorithm and the medical records (kappa = 0.84). The algorithm performed less well in identifying patients with a diagnosis of clinically significant DME (sensitivity, 0.86; specificity, 0.84; kappa = 0.64).Conclusions: The results of this pilot study suggest that patients with DME can be identified accurately in claims data using ICD-9-CM diagnosis codes. Application of this algorithm could improve investigations of disease prevalence and disease burden and provide an efficient means of assessing care and interventions.