Intraobserver and interobserver agreement of International Classification of Diseases, Ninth Revision codes in classifying shoulder instability.
Intraobserver and interobserver agreement of International Classification of Diseases, Ninth Revision codes in classifying shoulder instability.
复制标题
国际疾病分类第九版修订代码在肩部不稳定分类方面的观察者内和观察者间一致。
DOI：
10.1016/j.jse.2008.10.005
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发表时间：
2009
影响因子：
3
通讯作者：
Kuhn,JohnE
中科院分区：
文献类型：
--
作者：
Throckmorton,ThomasW;Dunn,Warren;Holmes,Tara;Kuhn,JohnE
本研究的目的是研究国际疾病分类第九版(ICD-9)系统应用于肩关节不稳定分类时观察者内和观察者间的可靠性。材料和方法2005年12月至2007年2月，主治医生使用16个ICD-9肩部不稳定代码中的一个对50例肩部不稳定患者进行了评估和分类。两周后，原内科医生和另外两名肩部专家对患者进行了重新评估。42名患者完成了这项研究。这些数据被分析以评估观察者内和观察者间的可靠性。结果观察者内对ICD-9编码的一致性为50%(κ=0.25，公平)。观察者间的符合率为23%(κ=0.002，差)。讨论ICD-9编码系统是公认的疾病状态分类标准，用于大型流行病学研究。这项研究表明，ICD-9编码系统的一致性很差，因此不是一种准确的肩关节不稳定分类方法。结论使用ICD-9编码系统不能可靠地对Shoulder不稳定进行分类。在开发出更可靠的系统之前，使用ICD-9代码的肩关节不稳定的流行病学研究可能很难解释。EVIDENCELevel 1级；测试以前开发的分类系统。
HYPOTHESISThe purpose of this study was to investigate the intraobserver and interobserver reliability of the International Classification of Diseases, Ninth Revision (ICD-9) system when applied to the classification of shoulder instability.MATERIALS AND METHODSFrom December 2005 through February 2007, 50 patients with shoulder instability were evaluated and classified by an attending physician using one of the 16 ICD-9 codes for shoulder instability. Patients were reassessed after two weeks by the original physician and two additional shoulder specialists. 42 patients completed the study. These data were then analyzed to assess intraobserver and interobserver reliability.RESULTSIntraobserver agreement for ICD-9 codes was 50% (κ=0.25, fair). Interobserver agreement was 23% (κ=0.002, poor).DISCUSSIONThe ICD-9 coding system is the recognized standard for classifying disease states and is used for large epidemiologic studies. The poor agreement demonstrated in this study suggests that the ICD-9 coding system has poor agreement and as such is not a precise method to classify shoulder instability.CONCLUSIONShoulder instability cannot reliably be classified using the ICD-9 coding system. Until a more reliable system is developed, epidemiologic studies of shoulder instability that use ICD-9 codes may be difficult to interpret.LEVEL OF EVIDENCELevel 1; Testing a previously developed classification system.