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Diagnostic accuracy of the International Classification of Diseases, Tenth Revision, codes of heart failure in an administrative database.
Pharmacoepidemiol Drug Saf. 2019 02; 28(2):194-200.PD

Abstract

PURPOSE

Heart failure (HF) is a common, serious, and still poorly known illness, which might benefit from studies in claims databases. However, to provide reliable estimates, HF patients must be adequately identified. This validation study aimed to estimate the diagnostic accuracy of the International Classification of Diseases, Tenth Revision (ICD-10) codes I50.x, heart failure, in the French hospital discharge diagnoses database.

METHODS

This study was performed in two university hospitals, comparing recorded discharge diagnoses and electronic health records (EHRs). Patients with discharge ICD-10 codes 150.x were randomly selected. Their EHRs were reviewed to classify HF diagnosis as definite, potential, or miscoded based on the European Society of Cardiology diagnostic criteria, from which the codes' positive predictive value (PPV) was computed. To estimate sensitivity, patients with an EHR HF diagnosis were identified, and the presence of the I50.x codes was sought for in the hospital discharge database.

RESULTS

Two hundred possible cases of HF were selected from the hospital discharge database, and 229 patients with an HF diagnosis were identified from the EHR. The PPV of I50.x codes was 60.5% (95% CI, 53.7%-67.3%) for definite HF and 88.0% (95% CI, 83.5%-92.5%) for definite/potential HF. The sensitivity of I50.x codes was 64.2% (95% CI, 58.0%-70.4%). PPV results were similar in both hospitals; sensitivity depended on the source of EHR: Departments of cardiology had a higher sensitivity than had nonspecialized wards.

CONCLUSIONS

Diagnosis codes I50.x in discharge summary databases accurately identify patients with HF but fail to capture some of them.

Authors+Show Affiliations

Univ. Bordeaux, Inserm, Bordeaux Population Health Research Centre, Team Pharmacoepidemiology, Bordeaux, France. Bordeaux PharmacoEpi, INSERM CIC1401, Bordeaux, France.CHU de Bordeaux, Bordeaux, France.CHU de Bordeaux, Bordeaux, France.CHU de Bordeaux, Bordeaux, France.Hôpital Européen Georges Pompidou, AP-HP, Paris, France.CHU de Bordeaux, Bordeaux, France.Bordeaux PharmacoEpi, INSERM CIC1401, Bordeaux, France.Hôpital Européen Georges Pompidou, AP-HP, Paris, France.Hôpital Européen Georges Pompidou, AP-HP, Paris, France. UMRS1138 Equipe 22, Université Paris Descartes, Paris, France.Univ. Bordeaux, Inserm, Bordeaux Population Health Research Centre, Team Pharmacoepidemiology, Bordeaux, France. Bordeaux PharmacoEpi, INSERM CIC1401, Bordeaux, France.

Pub Type(s)

Journal Article
Multicenter Study
Validation Study

Language

eng

PubMed ID

30395375

Citation

Bosco-Lévy, Pauline, et al. "Diagnostic Accuracy of the International Classification of Diseases, Tenth Revision, Codes of Heart Failure in an Administrative Database." Pharmacoepidemiology and Drug Safety, vol. 28, no. 2, 2019, pp. 194-200.
Bosco-Lévy P, Duret S, Picard F, et al. Diagnostic accuracy of the International Classification of Diseases, Tenth Revision, codes of heart failure in an administrative database. Pharmacoepidemiol Drug Saf. 2019;28(2):194-200.
Bosco-Lévy, P., Duret, S., Picard, F., Dos Santos, P., Puymirat, E., Gilleron, V., Blin, P., Chatellier, G., Looten, V., & Moore, N. (2019). Diagnostic accuracy of the International Classification of Diseases, Tenth Revision, codes of heart failure in an administrative database. Pharmacoepidemiology and Drug Safety, 28(2), 194-200. https://doi.org/10.1002/pds.4690
Bosco-Lévy P, et al. Diagnostic Accuracy of the International Classification of Diseases, Tenth Revision, Codes of Heart Failure in an Administrative Database. Pharmacoepidemiol Drug Saf. 2019;28(2):194-200. PubMed PMID: 30395375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of the International Classification of Diseases, Tenth Revision, codes of heart failure in an administrative database. AU - Bosco-Lévy,Pauline, AU - Duret,Stéphanie, AU - Picard,François, AU - Dos Santos,Pierre, AU - Puymirat,Etienne, AU - Gilleron,Véronique, AU - Blin,Patrick, AU - Chatellier,Gilles, AU - Looten,Vincent, AU - Moore,Nicholas, Y1 - 2018/11/05/ PY - 2017/11/23/received PY - 2018/09/14/revised PY - 2018/09/27/accepted PY - 2018/11/6/pubmed PY - 2020/3/24/medline PY - 2018/11/6/entrez KW - ICD-10 KW - accuracy KW - heart failure KW - pharmacoepidemiology KW - positive predictive value KW - sensitivity KW - validation study SP - 194 EP - 200 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 28 IS - 2 N2 - PURPOSE: Heart failure (HF) is a common, serious, and still poorly known illness, which might benefit from studies in claims databases. However, to provide reliable estimates, HF patients must be adequately identified. This validation study aimed to estimate the diagnostic accuracy of the International Classification of Diseases, Tenth Revision (ICD-10) codes I50.x, heart failure, in the French hospital discharge diagnoses database. METHODS: This study was performed in two university hospitals, comparing recorded discharge diagnoses and electronic health records (EHRs). Patients with discharge ICD-10 codes 150.x were randomly selected. Their EHRs were reviewed to classify HF diagnosis as definite, potential, or miscoded based on the European Society of Cardiology diagnostic criteria, from which the codes' positive predictive value (PPV) was computed. To estimate sensitivity, patients with an EHR HF diagnosis were identified, and the presence of the I50.x codes was sought for in the hospital discharge database. RESULTS: Two hundred possible cases of HF were selected from the hospital discharge database, and 229 patients with an HF diagnosis were identified from the EHR. The PPV of I50.x codes was 60.5% (95% CI, 53.7%-67.3%) for definite HF and 88.0% (95% CI, 83.5%-92.5%) for definite/potential HF. The sensitivity of I50.x codes was 64.2% (95% CI, 58.0%-70.4%). PPV results were similar in both hospitals; sensitivity depended on the source of EHR: Departments of cardiology had a higher sensitivity than had nonspecialized wards. CONCLUSIONS: Diagnosis codes I50.x in discharge summary databases accurately identify patients with HF but fail to capture some of them. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/30395375/Diagnostic_accuracy_of_the_International_Classification_of_Diseases_Tenth_Revision_codes_of_heart_failure_in_an_administrative_database_ L2 - https://doi.org/10.1002/pds.4690 DB - PRIME DP - Unbound Medicine ER -