Positive Predictive Value of ICD-10 Diagnosis Codes for COVID-19.
Positive Predictive Value of ICD-10 Diagnosis Codes for COVID-19.
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DOI：
10.2147/clep.s309840
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发表时间：
2021
影响因子：
3.9
通讯作者：
Omland LH
中科院分区：
文献类型：
--
作者：
Bodilsen J;Leth S;Nielsen SL;Holler JG;Benfield T;Omland LH
探讨国际分类第10版（ICD-10）对2019冠状病毒病（COVID-19）诊断代码的阳性预测值。对2020年2月27日至5月4日在丹麦六个传染病科被分配COVID-19诊断代码（DB342A或DB972A）的所有患者的病历进行审查。确诊的COVID-19诊断定义为：1)明确，呼吸道样本中出现严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）聚合酶链反应（PCR）阳性，并伴有提示COVID-19的症状；2)可能，临床表现为COVID-19，但未检测到SARS-CoV-2，且没有被认为更可能的其他诊断；或3)可能出现COVID-19临床表现，但未检测到SARS-CoV-2，并且在进行进一步调查之前患者已出院或死亡。我们以95%置信区间（CI）计算PPV，即确诊（即确诊、可能和可能）COVID-19的患者人数除以分配了COVID-19诊断代码的患者人数。研究纳入710例患者，中位年龄61岁（四分位数间距[IQR] 47-74），其中285/710例（40%）为女性。确诊病例706/710例（99%），确诊病例705/710例（99%），疑似病例1/710例（0.1%），疑似病例0例。在因细菌性肺炎（n = 2）、流感（n = 1）和尿路感染（n = 1）住院的710例患者中，有4例（0.6%）的诊断被否定。COVID-19的总体PPV为99% (95% CI 99-100)，并且在所有亚组（包括性别、年龄组、日历期，并按诊断代码和传染病部门分层）中始终保持较高水平（范围97-100%）。丹麦COVID-19诊断代码的总体PPV较高，可能适合未来基于登记的COVID-19预后研究。
To examine the positive predictive value (PPV) of International Classification version 10 (ICD-10) diagnosis codes for Coronavirus disease 2019 (COVID-19). Medical record review of all patients assigned a diagnosis code of COVID-19 (DB342A or DB972A) at six Danish departments of infectious diseases from February 27 through May 4, 2020. Confirmed COVID-19 diagnosis was defined as either: 1) definite, a positive polymerase chain reaction (PCR) for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) on a respiratory sample combined with symptoms suggestive of COVID-19: 2) probable, clinical presentation of COVID-19 without detection of SARS-CoV-2 and no alternative diagnoses considered more likely; or 3) possible, clinical presentation of COVID-19 without detection of SARS-CoV-2, and the patient was discharged or deceased before further investigations were carried out. We computed the PPV with 95% confidence intervals (CI) as the number of patients with confirmed (i.e., definite, probable, and possible) COVID-19 divided by the number of patients assigned a diagnosis code for COVID-19. The study included 710 patients with a median age of 61 years (interquartile range [IQR] 47–74) and 285/710 (40%) were female. COVID-19 was confirmed in 706/710 (99%) with 705/710 (99%) categorized as definite, 1/710 (0.1%) as probable, and 0 patients as possible COVID-19. The diagnosis was disproven in 4/710 (0.6%) patients who were hospitalized due to bacterial pneumonia (n = 2), influenza (n = 1), and urinary tract infection (n = 1). The overall PPV for COVID-19 was 99% (95% CI 99–100) and remained consistently high among all subgroups including sex, age groups, calendar period, and stratified by diagnosis code and department of infectious diseases (range 97–100%). The overall PPV of diagnosis codes for COVID-19 in Denmark was high and may be suitable for future registry-based prognosis studies of COVID-19.