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The 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden.

https://arctichealth.org/en/permalink/ahliterature124775
Source
Am J Geriatr Psychiatry. 2012 Nov;20(11):963-72
Publication Type
Article
Date
Nov-2012
Author
Nilsson, J
Östling, S
Waern, M
Karlsson, B
SigstrÖm, R
Xinxin Guo
Ingmar Skoog
Author Affiliation
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
Am J Geriatr Psychiatry. 2012 Nov;20(11):963-72
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - diagnosis - epidemiology - psychology
Anxiety Disorders - diagnosis - epidemiology - psychology
Chronic Disease - epidemiology - psychology
Comorbidity
Cross-Sectional Studies
Depressive Disorder, Major - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Female
Geriatric Assessment - statistics & numerical data
Health Behavior
Health Surveys
Humans
International Classification of Diseases
Interview, Psychological
Life Style
Male
Obsessive-Compulsive Disorder - diagnosis - epidemiology - psychology
Phobic Disorders - diagnosis - epidemiology - psychology
Sweden
Abstract
To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression.
During 2005-2006, a comprehensive semistructured psychiatric interview was conducted by trained nurses in a representative population sample of 75-year-olds without dementia in Gothenburg, Sweden (N = 777; 299 men and 478 women). All psychiatric diagnoses were made according to DSM-IV. GAD was also diagnosed according to ICD-10 and DSM-V.
The 1-month prevalence of GAD was 4.1% (N = 32) according to DSM-IV, 4.5% (N = 35) according to DSM-V, and 3.7% (N = 29) according to ICD-10. Only 46.9% of those with DSM-IV GAD fulfilled ICD-10 criteria, and only 51.7% and 44.8% of those with ICD-10 GAD fulfilled DSM-IV/V criteria. Instead, 84.4% and 74.3% of those with DSM-IV/V GAD and 89.7% of those with ICD-10 GAD had depression. Also other psychiatric diagnoses were common in those with ICD-10 and DSM-IV GAD. Only a small minority with GAD, irrespective of criteria, had no other comorbid psychiatric disorder. ICD-10 GAD was related to an increased mortality rate.
While GAD was common in 75-year-olds, DSM-IV/V and ICD-10 captured different individuals. Current definitions of GAD may comprise two different expressions of the disease. There was greater congruence between GAD in either classification system and depression than between DSM-IV/V GAD and ICD-10 GAD, emphasizing the close link between these entities.
PubMed ID
22549369 View in PubMed
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Accuracy of coding for possible warfarin complications in hospital discharge abstracts.

https://arctichealth.org/en/permalink/ahliterature173437
Source
Thromb Res. 2006;118(2):253-62
Publication Type
Article
Date
2006
Author
T. Arnason
P S Wells
C. van Walraven
A J Forster
Author Affiliation
Ottawa Health Research Institute-Clinical Epidemiology Program, Canada.
Source
Thromb Res. 2006;118(2):253-62
Date
2006
Language
English
Publication Type
Article
Keywords
Anticoagulants - therapeutic use
Canada
Hemorrhage - complications
Hospitals, University
Humans
International Classification of Diseases
Medical Records
Reproducibility of Results
Retrospective Studies
Thromboembolism - complications
Warfarin - therapeutic use
Abstract
Hospital discharge abstracts could be used to identify complications of warfarin if coding for bleeding and thromboembolic events are accurate.
To measure the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) codes for bleeding and thromboembolic diagnoses.
University affiliated, tertiary care hospital in Ottawa, Canada.
A random sample of patients discharged between September 1999 and September 2000 with an ICD-9-CM code indicating a bleeding or thromboembolic diagnosis.
Gold-standard coding was determined by a trained chart abstractor using explicit standard diagnostic criteria for bleeding, major bleeding, and acute thromboembolism. The abstractor was blinded to the original coding. We calculated the sensitivity, specificity, positive, and negative predictive values of the original ICD-9CM codes for bleeding or thromboembolism diagnoses.
We reviewed 616 medical records. 361 patients (59%) had a code indicating a bleeding diagnosis, 291 patients (47%) had a code indicating a thromboembolic diagnosis and 36 patients (6%) had a code indicating both. According to the gold standard criteria, 352 patients experienced bleeding, 333 experienced major bleeding, and 188 experienced an acute thromboembolism. For bleeding, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values [95% CI]: 93% [90-96], 88% [83-91], 91% [88-94], and 91% [87-94], respectively. For major bleeding, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values: 94% [91-96], 83% [78-87], 87% [83-90], and 92% [88-95], respectively. For thromboembolism, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values: 97% [94-99], 74% [70-79], 62% [57-68], and 98% [96-99], respectively. By selecting a sub-group of ICD-9CM codes for thromboembolism, the positive predictive value increased to 87%.
In our centre, the discharge abstract could be used to identify and exclude patients hospitalized with a major bleed or thromboembolism. If coding quality for bleeding is similar in other hospitals, these ICD-9-CM diagnostic codes could be used to study population-based warfarin-associated hemorrhagic complications using administrative databases.
PubMed ID
16081144 View in PubMed
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Accuracy of ovarian cancer ICD-10 diagnosis in a Danish population-based hospital discharge registry.

https://arctichealth.org/en/permalink/ahliterature16919
Source
Eur J Gynaecol Oncol. 2005;26(3):266-70
Publication Type
Article
Date
2005
Author
M S Tetsche
M. Nørgaard
M V Skriver
E S Andersen
T L Lash
H T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, Denmark.
Source
Eur J Gynaecol Oncol. 2005;26(3):266-70
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Comparative Study
Denmark - epidemiology
Female
Humans
International Classification of Diseases - standards
Middle Aged
Ovarian Neoplasms - diagnosis - mortality
Registries
Research Support, Non-U.S. Gov't
Survival Analysis
Abstract
OBJECTIVE: We estimated the accuracy of ICD-10 diagnosis of ovarian cancer in a Danish discharge registry (HDR) by comparing it with Cancer Registry data (DCR). STUDY DESIGN AND SETTING: Patients (N=489) living in North Jutland County, Denmark with ovarian cancer or borderline tumour registered in the HDR or the DCR. We estimated the completeness and positive predictive value (PPV) of ovarian cancer discharge diagnosis. Mortality rates were constructed for both registries. RESULTS: The completeness in the HDR for ovarian cancer was 96% (95% confidence interval [CI]: 94%-98%) and PPV was 87% (95% CI: 85%-90%). 87 (18%) of the patients coded with ovarian cancer in the HDR had borderline tumours. When borderline tumours were excluded from the DCR, the PPV declined to 69% and the completeness did not change. The mortality rate ratio for ovarian cancer registered in the HDR compared to the DCR was 1.08 (95% CI: 0.90-1.29). CONCLUSION: The discharge data (ICD-10) had some misclassification, but can be a valuable tool in assessment of the prognosis of ovarian cancer.
PubMed ID
15991523 View in PubMed
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Accuracy of syndrome definitions based on diagnoses in physician claims.

https://arctichealth.org/en/permalink/ahliterature138094
Source
BMC Public Health. 2011;11:17
Publication Type
Article
Date
2011
Author
Geneviève Cadieux
David L Buckeridge
André Jacques
Michael Libman
Nandini Dendukuri
Robyn Tamblyn
Author Affiliation
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. genevieve.cadieux@mail.mcgill.ca
Source
BMC Public Health. 2011;11:17
Date
2011
Language
English
Publication Type
Article
Keywords
Clinical Coding - methods
Community Health Services - utilization
Data Collection
Diagnostic Techniques and Procedures - standards
Exanthema - classification - diagnosis
Female
Fever - classification - diagnosis
Humans
International Classification of Diseases
Male
Nervous System Diseases - classification - diagnosis
Office Visits - utilization
Population Surveillance - methods
Quebec
Registries
Respiratory Tract Infections - classification - diagnosis
Sensitivity and specificity
Abstract
Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics.
We selected a random sample of 3,600 community-based primary care physicians who practiced in the fee-for-service system in the province of Quebec, Canada in 2005-2007. We randomly selected 10 visits per physician from their claims, stratifying on syndrome type and presence, diagnosis, and month. Double-blinded chart reviews were conducted by telephone with consenting physicians to obtain information on patient diagnoses for each sampled visit. The sensitivity, specificity, and positive predictive value (PPV) of physician claims were estimated by comparison to chart review.
1,098 (30.5%) physicians completed the chart review. A chart entry on the date of the corresponding claim was found for 10,529 (95.9%) visits. The sensitivity of syndrome definitions based on diagnostic codes in physician claims was low, ranging from 0.11 (fever) to 0.44 (respiratory), the specificity was high, and the PPV was moderate to high, ranging from 0.59 (fever) to 0.85 (respiratory). We found that rarely used diagnostic codes had a higher probability of being false-positives, and that more commonly used diagnostic codes had a higher PPV.
Future research should identify physician, patient, and encounter characteristics associated with the accuracy of diagnostic codes in physician claims. This would enable public health to improve syndromic surveillance, either by focusing on physician claims whose diagnostic code is more likely to be accurate, or by using all physician claims and weighing each according to the likelihood that its diagnostic code is accurate.
Notes
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PubMed ID
21211054 View in PubMed
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The accuracy of the clinical diagnosis of Parkinson disease. The HUNT study.

https://arctichealth.org/en/permalink/ahliterature301152
Source
J Neurol. 2018 Sep; 265(9):2120-2124
Publication Type
Journal Article
Date
Sep-2018
Author
Eldbjørg Hustad
Anne Heidi Skogholt
Kristian Hveem
Jan O Aasly
Author Affiliation
Department of Neurology, Molde Hospital, Møre and Romsdal Hospital Trust, Molde, Norway. Eldbjorh@stud.ntnu.no.
Source
J Neurol. 2018 Sep; 265(9):2120-2124
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Diagnostic Errors
Electronic Health Records
Humans
International Classification of Diseases
Norway
Parkinson Disease - diagnosis
Parkinson Disease, Secondary - diagnosis
Quality Assurance, Health Care
Registries
Abstract
Diagnostic accuracy is crucial not only for prognostic and therapeutic reasons, but also for epidemiologic studies. We aimed to study the accuracy of the clinical diagnosis of Parkinson disease (PD) for participants in The Nord-Trøndelag Health Study (HUNT), a health survey, containing data from approximately 126,000 individuals and biological material from 80,000 individuals. We included 980 participants from the HUNT study diagnosed with PD or secondary parkinsonism/related parkinsonian disorders. The participants had been diagnosed in conjunction with admission to hospitals in Trøndelag or through out-patient examination. We validated the diagnosis of PD by reviewing available Electronic Health Records (EHRs) using the MDS Clinical Diagnostic Criteria as gold standard. In total 61% (601/980) of the participants had available EHRs and were selected for validation. Out of those, 92% (550/601) had been diagnosed with PD while 8% (51/601) had been diagnosed with secondary parkinsonism/related parkinsonian disorders. The main outcome measure was the accuracy of the clinical diagnosis of PD for participants in the HUNT study. We verified PD in 65% (358/550) and excluded PD in 35% (192/550) of the participants. According to our results, the overall quality of the clinical diagnosis of PD for participants in the HUNT study is not optimal. Quality assurance of ICD codes entered into health registers is crucial before biological material obtained from these populations can be used in the search of new biomarkers for PD.
PubMed ID
29992351 View in PubMed
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Accuracy of the ICD-10 discharge diagnosis for syncope.

https://arctichealth.org/en/permalink/ahliterature119178
Source
Europace. 2013 Apr;15(4):595-600
Publication Type
Article
Date
Apr-2013
Author
Martin Huth Ruwald
Morten Lock Hansen
Morten Lamberts
Søren Lund Kristensen
Mads Wissenberg
Anne-Marie Schjerning Olsen
Stefan Bisgaard Christensen
Michael Vinther
Lars Køber
Christian Torp-Pedersen
Jim Hansen
Gunnar Hilmar Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. mruwald@hotmail.com
Source
Europace. 2013 Apr;15(4):595-600
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Denmark - epidemiology
Emergency Service, Hospital - statistics & numerical data
Female
Humans
International Classification of Diseases - statistics & numerical data
Male
Middle Aged
Patient Discharge - statistics & numerical data
Predictive value of tests
Reproducibility of Results
Retrospective Studies
Risk factors
Syncope - diagnosis - epidemiology
Abstract
Administrative discharge codes are widely used in epidemiology, but the specificity and sensitivity of this coding is unknown and must be validated. We assessed the validity of the discharge diagnosis of syncope in administrative registers and reviewed the etiology of syncope after workup.
Two samples were investigated. One sample consisted of 5262 randomly selected medical patients. The other sample consisted of 750 patients admitted or seen in the emergency department (ED) for syncope (ICD-10: R55.9) in three hospitals in Denmark. All charts were reviewed for baseline characteristics and to confirm the presence/absence of syncope and to compare with the administrative coding. In a sample of 600 admitted patients 570 (95%) and of 150 patients from ED 140 (93%) had syncope representing the positive predictive values. Median age of the population was 69 years (IQR: ± 14). In the second sample of 5262 randomly selected medical patients, 75 (1.4%) had syncope, of which 47 were coded as R55.9 yielding a sensitivity of 62.7%, a negative predictive value of 99.5%, and a specificity of 99.9%.
ED and hospital discharge diagnostic coding for syncope has a positive predictive value of 95% and a sensitivity of 63%.
PubMed ID
23129545 View in PubMed
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Achalasia: incidence, prevalence and survival. A population-based study.

https://arctichealth.org/en/permalink/ahliterature143579
Source
Neurogastroenterol Motil. 2010 Sep;22(9):e256-61
Publication Type
Article
Date
Sep-2010
Author
D C Sadowski
F. Ackah
B. Jiang
L W Svenson
Author Affiliation
GI Motility Laboratory, Royal Alexandra Hospital, University of Alberta, Edmonton, AB, Canada. dan.sadowski@ualberta.ca
Source
Neurogastroenterol Motil. 2010 Sep;22(9):e256-61
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Aged
Aged, 80 and over
Alberta - epidemiology
Child
Child, Preschool
Databases, Factual
Esophageal Achalasia - epidemiology
Female
Humans
Incidence
International Classification of Diseases
Kaplan-Meier Estimate
Male
Middle Aged
Prevalence
Survival Rate
Abstract
Studies of achalasia epidemiology are important as they often yield new insights into disease etiology. In this study, our objective was to carry out the first North American population-based study of achalasia epidemiology using a governmental administrative database.
All residents in the province of Alberta, Canada receive universal healthcare coverage as a benefit. The provincial health ministry, Alberta Health and Wellness, maintains a central stakeholder database of patient demographic information and physician billing claims. We defined an achalasia case as a billing claim submitted for the years 1996-2007 with an ICD-9-CM code of 530.0 or 530 and a Canadian Classification of Procedure treatment code of 54.92A (endoscopic balloon dilation) or 54.6 (esophagomyotomy). A preliminary validation study of the case definition demonstrated a sensitivity of 85% and specificity of 99% for known cases and controls.
A total of 463 achalasia cases were identified from 1995 to 2008 (59.6% males). Mean age at diagnosis was 53.1 years. In 2007, the achalasia incidence was 1.63/100,000 (95% CI 1.20, 2.06) and the prevalence was 10.82/100,000 (95% CI 9.70, 11.93). We observed a steady increase in the overall prevalence rate from 2.51/100,000 in 1996 to 10.82/100,000 in 2007. Survival of achalasia cases was significantly less than age-sex matched population controls (P
PubMed ID
20465592 View in PubMed
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ADHD, comorbid disorders and psychosocial functioning: How representative is a child cohort study? Findings from a national patient registry.

https://arctichealth.org/en/permalink/ahliterature284629
Source
BMC Psychiatry. 2017 Jan 17;17(1):23
Publication Type
Article
Date
Jan-17-2017
Author
Beate Oerbeck
Kristin Romvig Overgaard
Stian Thoresen Aspenes
Are Hugo Pripp
Marianne Mordre
Heidi Aase
Ted Reichborn-Kjennerud
Pal Zeiner
Source
BMC Psychiatry. 2017 Jan 17;17(1):23
Date
Jan-17-2017
Language
English
Publication Type
Article
Keywords
Attention Deficit Disorder with Hyperactivity - diagnosis - epidemiology - psychology
Child
Cohort Studies
Comorbidity
Female
Humans
International Classification of Diseases
Interpersonal Relations
Male
Mothers - psychology
Neurodevelopmental Disorders - diagnosis - epidemiology - psychology
Norway - epidemiology
Prospective Studies
Registries
Abstract
Cohort studies often report findings on children with Attention Deficit Hyperactivity Disorder (ADHD) but may be biased by self-selection. The representativeness of cohort studies needs to be investigated to determine whether their findings can be generalised to the general child population. The aim of the present study was to examine the representativeness of child ADHD in the Norwegian Mother and Child Cohort Study (MoBa).
The study population was children born between January 1, 2000 and December 31, 2008 registered with hyperkinetic disorders (hereafter ADHD) in the Norwegian Patient Registry during the years 2008-2013, and two groups of children with ADHD were identified in: 1. MoBa and 2. The general child population. We used the multiaxial International Classification of Diseases (ICD-10) and compared the proportions of comorbid disorders (axes I-III), abnormal psychosocial situations (axis V) and child global functioning (axis VI) between these two groups. We also compared the relative differences in the multiaxial classifications for boys and girls and for children with/without axis I comorbidity, respectively in these two groups of children with ADHD.
A total of 11 119 children were registered with ADHD, with significantly fewer in MoBa (1.45%) than the general child population (2.11%), p
Notes
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PubMed ID
28095819 View in PubMed
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Amniotic fluid chemokines and autism spectrum disorders: an exploratory study utilizing a Danish Historic Birth Cohort.

https://arctichealth.org/en/permalink/ahliterature131145
Source
Brain Behav Immun. 2012 Jan;26(1):170-6
Publication Type
Article
Date
Jan-2012
Author
Morsi W Abdallah
Nanna Larsen
Jakob Grove
Bent Nørgaard-Pedersen
Poul Thorsen
Erik L Mortensen
David M Hougaard
Author Affiliation
Department of Epidemiology, Aarhus University School of Public Health, Aarhus, Denmark. mab@soci.au.dk
Source
Brain Behav Immun. 2012 Jan;26(1):170-6
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adult
Amniotic Fluid - metabolism
Case-Control Studies
Chemokine CCL2 - analysis - metabolism
Chemokine CCL3 - analysis - metabolism
Chemokine CCL5 - metabolism
Chemokines - metabolism
Child
Child Development Disorders, Pervasive - epidemiology - metabolism
Cohort Studies
Congenital Abnormalities - epidemiology
Denmark - epidemiology
Female
Gestational Age
Humans
International Classification of Diseases
Logistic Models
Maternal Age
Mental Disorders - epidemiology
Odds Ratio
Pregnancy
Abstract
Elevated levels of chemokines have been reported in plasma and brain tissue of individuals with Autism Spectrum Disorders (ASD). The aim of this study was to examine chemokine levels in amniotic fluid (AF) samples of individuals diagnosed with ASD and their controls.
A Danish Historic Birth Cohort (HBC) kept at Statens Serum Institute, Copenhagen was utilized. Using data from Danish nation-wide health registers, a case-control study design of 414 cases and 820 controls was adopted. Levels of MCP-1, MIP-1a and RANTES were analyzed using Luminex xMAP technology. Case-control differences were assessed as dichotomized at below the 10th percentile or above the 90th percentile cut-off points derived from the control biomarker distributions (logistic regression) or continuous measures (tobit regression).
AF volume for 331 cases and 698 controls was sufficient for Luminex analysis. Including all individuals in the cohort yielded no significant differences in chemokine levels in cases versus controls. Logistic regression analyses, performed on individuals diagnosed using ICD-10 only, showed increased risk for ASD with elevated MCP-1 (elevated 90th percentile adjusted OR: 2.32 [95% CI: 1.17-4.61]) compared to controls. An increased risk for infantile autism with elevated MCP-1 was also found (adjusted OR: 2.28 [95% CI: 1.16-4.48]). Elevated levels of MCP-1 may decipher an etiologic immunologic dysfunction or play rather an indirect role in the pathophysiology of ASD. Further studies to confirm its role and to identify the potential pathways through which MCP-1 may contribute to the development of ASD are necessary.
Notes
Comment In: Brain Behav Immun. 2012 Mar;26(3):39322001185
PubMed ID
21933705 View in PubMed
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An administrative data algorithm to identify traumatic spinal cord injured patients: a validation study.

https://arctichealth.org/en/permalink/ahliterature106228
Source
Spinal Cord. 2014 Jan;52(1):34-8
Publication Type
Article
Date
Jan-2014
Author
B. Welk
E. Loh
S Z Shariff
K. Liu
F. Siddiqi
Author Affiliation
1] Department of Surgery, Western University, London, Ontario, Canada [2] Institute for Clinical Evaluative Sciences-Western (ICES Western), London, Ontario, Canada.
Source
Spinal Cord. 2014 Jan;52(1):34-8
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Adult
Algorithms
Clinical Coding - methods - standards
Female
Humans
International Classification of Diseases
Male
Middle Aged
Ontario
Spinal Cord Injuries - classification
Abstract
To assess the validity of different administrative data sources available for the identification of traumatic spinal cord injured (TSCI) patients.
Retrospective validation study.
Ontario, Canada.
Adult patients seen in tertiary outpatient spinal cord rehabilitation clinics after 1 April 2002.
Sensitivity, specificity, positive and negative predicative values of diagnostic ICD10 codes from Canadian Institutes of Health Discharge Abstracts (CIHI-DAD), Rehabilitation Coding Groups (RCG) from that National Rehabilitation System (NRS), and spinal cord injury fee codes from the Ontario Healthcare Insurance Plan (OHIP). Secondary outcome was the agreement between actual lesion level and RCG/ICD10 coded lesion level.
The RCG codes in the NRS have high sensitivity (92%, 95% confidence interval (CI): 87-95%) and specificity (97%, 95% CI: 94-99%) for the identification of true TSCI patients, whereas CIHI-DAD ICD10 codes are highly specific (99%, 95% CI: 95-100) and moderately sensitive (76%, 95% CI: 79-87%). OHIP fee codes had poor sensitivity (64%, 95% CI: 57-71%). Agreement between true lesion level and the NRS and CIHI-DAD coding is good (Kappa of 0.65-0.88 and 0.56-0.70, respectively).
This study demonstrated that the NRS is able to accurately discriminate between patients with and without a TSCI. A large population of incident and prevalent TSCI patients are identifiable using administrative data.
This study was funded by a grant from the Division of Urology, Western University.
PubMed ID
24216615 View in PubMed
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