Improving accuracy of International Classification of Diseases codes for venous thromboembolism in administrative data
Improving accuracy of International Classification of Diseases codes for venous thromboembolism in administrative data
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DOI：
10.1016/j.thromres.2015.01.012
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发表时间：
2015-04-01
影响因子：
7.5
通讯作者：
Carson, Kenneth R.
中科院分区：
文献类型：
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作者：
Sanfilippo, Kristen M.;Wang, Tzu-Fei;Carson, Kenneth R.
背景：临床医生和研究人员越来越多地使用管理数据进行临床和结果研究。然而，他们继续质疑的准确性，单独使用国际疾病分类第9次修订版（ICD-9）代码捕捉诊断，特别是静脉血栓栓塞症（VTE），在administrative data.Objectives：我们测试的假设，将治疗数据和/或共同的程序术语（CPT）代码可以提高行政数据在检测静脉血栓栓塞症的准确性。研究设计使用退伍军人事务部中央癌症登记处，我们比较了三个竞争的算法进行三个横断面研究。算法1仅通过ICD-9代码识别患者。除ICD-9代码外，算法2还需要VTE治疗。算法3除了治疗和ICD-9 criteria.Results外，还需要一个VTE诊断CPT代码：单独使用ICD-9代码检测VTE的准确性很低，PPV为72%。添加治疗数据后，PPV改善至91%（算法2）。与算法2相比，CPT编码（算法3）并未显著提高VTE的检出准确性（PPV 92%），但敏感性从72%降至67%。结论：在ICD-9编码中加入治疗数据后，VTE检出准确性显著提高。这种方法应便于使用管理数据来评估VTE的发病率、流行病学和结局。爱思唯尔有限公司出版
Background: Increasingly, clinicians and researchers are using administrative data for clinical and outcomes research. However, they continue to question the accuracy of using International Classification of Diseases 9th Revision (ICD-9) codes alone to capture diagnoses, especially venous thromboembolism(VTE), in administrative data.Objectives: We tested the hypothesis that incorporation of treatment data and/or common procedural terminology (CPT) codes could improve accuracy of administrative data in detecting VTE. Research Design Using the Veterans Affairs Central Cancer Registry, we compared three competing algorithms by performing three cross-sectional studies. Algorithm 1 identified patients by ICD-9 codes alone. Algorithm 2 required VTE treatment in addition to ICD-9 codes. Algorithm 3 required a VTE diagnostic CPT code in addition to treatment and ICD-9 criteria.Results: The accuracy of ICD-9 codes alone for detection of VTE was marginal, with a PPV of 72%. The PPV was improved to 91% after addition of treatment data (algorithm 2). As compared to algorithm 2, addition of CPT codes (algorithm 3) did not significantly increase the accuracy of detecting VTE (PPV 92%), but decreased sensitivity from 72% to 67%.Conclusions: Accuracy of VTE detection significantly improved with addition of treatment data to ICD-9 codes. This approach should facilitate use of administrative data to assess the incidence, epidemiology, and outcomes of VTE. Published by Elsevier Ltd.