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Validation of ICD-9-CM codes to identify gastrointestinal perforation events in administrative claims data among hospitalized rheumatoid arthritis patients.
Pharmacoepidemiol Drug Saf. 2011 Nov; 20(11):1150-8.PD

Abstract

PURPOSE

To validate, using physician review of abstracted medical chart data as a gold standard, a claims-based algorithm developed to identify gastrointestinal (GI) perforation cases among rheumatoid arthritis (RA) patients.

METHODS

Patients with established RA, aged 18 years or older with hospital admissions between January 2004 and September 2009, were selected from a large US-hospital-based database. An algorithm with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes for GI perforation and combinations of GI-related diagnosis codes and Current Procedural Terminology (CPT-4) procedure codes for relevant GI surgeries was used to identify potential GI perforation cases. Two senior experienced specialist physicians independently reviewed abstracted chart data and classified cases as confirmed or unconfirmed GI perforations. Positive predictive values (PPVs) to identify confirmed GI perforation were calculated and stratified by upper versus lower GI tract.

RESULTS

Overall, 86 of 92 GI perforation cases were confirmed, yielding an overall PPV of 94% (95%confidence interval [CI] = 86%-98%). PPV was 100% (95%CI = 100%-100%) for upper GI perforation (esophagus, stomach) and 91% (95%CI = 90%-97%) for lower GI perforation (small intestine, PPV = 100%; large intestine, PPV = 94%; unspecified lower GI, PPV = 89%).

CONCLUSIONS

This algorithm, consisting of a combination of ICD-9-CM diagnosis and CPT-4 codes, could be used in future safety studies to evaluate GI perforation risk factors in RA patients.

Authors+Show Affiliations

Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, FOT 805D, 510 20th Street South, Birmingham, AL 35294, USA. jcurtis@uab.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

22020901

Citation

Curtis, Jeffrey R., et al. "Validation of ICD-9-CM Codes to Identify Gastrointestinal Perforation Events in Administrative Claims Data Among Hospitalized Rheumatoid Arthritis Patients." Pharmacoepidemiology and Drug Safety, vol. 20, no. 11, 2011, pp. 1150-8.
Curtis JR, Chen SY, Werther W, et al. Validation of ICD-9-CM codes to identify gastrointestinal perforation events in administrative claims data among hospitalized rheumatoid arthritis patients. Pharmacoepidemiol Drug Saf. 2011;20(11):1150-8.
Curtis, J. R., Chen, S. Y., Werther, W., John, A., & Johnson, D. A. (2011). Validation of ICD-9-CM codes to identify gastrointestinal perforation events in administrative claims data among hospitalized rheumatoid arthritis patients. Pharmacoepidemiology and Drug Safety, 20(11), 1150-8. https://doi.org/10.1002/pds.2215
Curtis JR, et al. Validation of ICD-9-CM Codes to Identify Gastrointestinal Perforation Events in Administrative Claims Data Among Hospitalized Rheumatoid Arthritis Patients. Pharmacoepidemiol Drug Saf. 2011;20(11):1150-8. PubMed PMID: 22020901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of ICD-9-CM codes to identify gastrointestinal perforation events in administrative claims data among hospitalized rheumatoid arthritis patients. AU - Curtis,Jeffrey R, AU - Chen,Shih-Yin, AU - Werther,Winifred, AU - John,Ani, AU - Johnson,David A, Y1 - 2011/08/27/ PY - 2010/12/08/received PY - 2011/06/02/revised PY - 2011/06/22/accepted PY - 2011/10/25/entrez PY - 2011/10/25/pubmed PY - 2012/8/14/medline SP - 1150 EP - 8 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 20 IS - 11 N2 - PURPOSE: To validate, using physician review of abstracted medical chart data as a gold standard, a claims-based algorithm developed to identify gastrointestinal (GI) perforation cases among rheumatoid arthritis (RA) patients. METHODS: Patients with established RA, aged 18 years or older with hospital admissions between January 2004 and September 2009, were selected from a large US-hospital-based database. An algorithm with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes for GI perforation and combinations of GI-related diagnosis codes and Current Procedural Terminology (CPT-4) procedure codes for relevant GI surgeries was used to identify potential GI perforation cases. Two senior experienced specialist physicians independently reviewed abstracted chart data and classified cases as confirmed or unconfirmed GI perforations. Positive predictive values (PPVs) to identify confirmed GI perforation were calculated and stratified by upper versus lower GI tract. RESULTS: Overall, 86 of 92 GI perforation cases were confirmed, yielding an overall PPV of 94% (95%confidence interval [CI] = 86%-98%). PPV was 100% (95%CI = 100%-100%) for upper GI perforation (esophagus, stomach) and 91% (95%CI = 90%-97%) for lower GI perforation (small intestine, PPV = 100%; large intestine, PPV = 94%; unspecified lower GI, PPV = 89%). CONCLUSIONS: This algorithm, consisting of a combination of ICD-9-CM diagnosis and CPT-4 codes, could be used in future safety studies to evaluate GI perforation risk factors in RA patients. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/22020901/Validation_of_ICD_9_CM_codes_to_identify_gastrointestinal_perforation_events_in_administrative_claims_data_among_hospitalized_rheumatoid_arthritis_patients_ L2 - https://doi.org/10.1002/pds.2215 DB - PRIME DP - Unbound Medicine ER -