Determining the test characteristics of claims-based diagnostic codes for the diagnosis of venous thromboembolism in a medical service claims database
Determining the test characteristics of claims-based diagnostic codes for the diagnosis of venous thromboembolism in a medical service claims database
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DOI：
10.1002/pds.2061
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发表时间：
2011-03-01
影响因子：
2.6
通讯作者：
Kahn, Susan R.
中科院分区：
文献类型：
--
作者：
Tagalakis, Vicky;Kahn, Susan R.
目的 确定医疗服务索赔数据库中深静脉血栓 (DVT) 和肺栓塞 (PE) 诊断代码的测试特征。方法 魁北克省医疗保障局 (RAMQ) 负责管理加拿大魁北克省的健康保险计划。 RAMQ 索赔数据是从 2001 年 4 月至 2002 年 7 月参与静脉血栓形成结果 (VETO) 研究的客观诊断 DVT 伴或不伴 PE 的受试者获得的。使用 VETO 记录中 DVT 和 PE 诊断的日期作为参考标准，根据 RAMQ 诊断代码正确分类的受试者比例确定了 DVT 和 PE 发生的确切日期以及围绕该日期的四个扩展时间窗口。 结果 总共 355 VETO纳入的患者中，301 名仅患有 DVT，54 名患有 DVT 和 PE。总体而言，97% 的 VETO 病例具有 DVT 的 RAMQ 诊断代码，82% 的 PE VETO 病例具有 PE 的 RAMQ 诊断代码。对于准确的诊断日期，DVT 和 PE 的敏感性分别为 52%（95% CI，47-57）和 35%（95% CI，23-49），而对于该日期周围的 60 天窗口，DVT 和 PE 的敏感性分别为 87%（95% CI，83-90）和 78%（95% CI，64-88）。由于所有 VETO 参与者均患有 DVT，因此无法确定 DVT 诊断的特异性。结论 医疗服务索赔数据库中的诊断代码是 DVT 和 PE 相对敏感的指标，可以考虑将索赔数据用于 VTE 研究目的。版权所有 (C) 2010 约翰·威利父子有限公司
Purpose To determine the test characteristics of diagnostic codes within a medical service claims database for deep vein thrombosis (DVT) and pulmonary embolism (PE).Methods The Regie de l' Assurance Maladie du Quebec (RAMQ) administers the health insurance program in Quebec, Canada. RAMQ claims data were obtained for subjects with objectively diagnosed DVT with or without PE who were participants in the Venous Thrombosis Outcomes (VETO) Study from April 2001 to July 2002. Using the date of DVT and PE diagnosis in the VETO record as the reference standard, the proportion of subjects correctly classified by RAMQ diagnostic codes was determined for the exact date of DVT and PE occurrence and for four expanded time windows around this date.Results In all, 355 VETO patients were included, 301 with DVT alone and 54 with DVT and PE. Overall, 97% of VETO cases had a RAMQ diagnostic code for DVT and 82% of VETO cases with PE had a RAMQ diagnostic code for PE. Sensitivity for DVT and PE was 52% (95% confidence interval (CI), 47-57) and 35% (95% CI, 23-49), respectively for the exact date of diagnosis, and 87% (95% CI, 83-90) and 78% (95% CI, 64-88), respectively for a 60-day window around this date. As all VETO participants had DVT, specificity for the diagnosis of DVT could not be determined.Conclusion Diagnostic codes within a medical service claims database are relatively sensitive indicators for DVT and PE, and use of claims data for VTE research purposes can be considered. Copyright (C) 2010 John Wiley & Sons, Ltd.