Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System
Background International Classification of Diseases-9 (ICD-9) codes are useful in clinical research; however, the validity of ICD-9 codes for inflammatory bowel disease (IBD) patients in multiple centers in the Veterans Affairs Health Care Systems (VA) has not been established. Our aim was to determ...
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| Veröffentlicht in: | Digestive diseases and sciences 2014-10, Vol.59 (10), p.2406-2410 |
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| creator | Hou, Jason K. Tan, Mimi Stidham, Ryan W. Colozzi, John Adams, Devon El-Serag, Hashem Waljee, Akbar K. |
| description | Background
International Classification of Diseases-9 (ICD-9) codes are useful in clinical research; however, the validity of ICD-9 codes for inflammatory bowel disease (IBD) patients in multiple centers in the Veterans Affairs Health Care Systems (VA) has not been established. Our aim was to determine the accuracy of ICD-9 codes for Crohn’s disease (CD) and ulcerative colitis (UC) in the VA.
Methods
Patients with a diagnosis of IBD during 1999–2009 were identified by at least one ICD-9 code for CD (555.x) or UC (556.x) at the Houston and Ann Arbor VA Medical Centers and confirmed by chart review. A diagnosis of CD, UC, and IBD, unspecified (IBDU) was determined based on structured review of data in the VA medical records. Positive predictive values (PPV) were calculated for the codes using previously published ICD-9 algorithms.
Results
A total of 1,871 patients were identified with ICD-9 codes for IBD. Of these patients, 1,298 (69 %) were confirmed to have IBD, with 541 CD (41 %), 707 UC (55 %), and 50 IBDU (4 %) patients. An algorithm of 2 or more codes with at least one from an outpatient encounter improved the PPV (0.83 and 0.89 for CD and UC, respectively) compared a single code algorithm (PPV 0.59 and 0.66, respectively).
Conclusion
Single ICD-9 codes are inadequate to accurately define IBD patients; however, ICD-9 code algorithms can be used to identify patients with UC or CD with high positive predictive value. The
2 code, at least 1 outpatient
code algorithm was observed to have a high PPV and low miss rate. |
| doi_str_mv | 10.1007/s10620-014-3174-7 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6907154</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712942222</galeid><sourcerecordid>A712942222</sourcerecordid><originalsourceid>FETCH-LOGICAL-c640t-612b0d3b638ef48a3a9395450d6c112754510d69b0f72987286f33a0302df87e3</originalsourceid><addsrcrecordid>eNqFks1uEzEQx1cIREPhAbggS1y4bPHHru29IEXLRytVAgnK1XK848TVxi72pig3noA7r8eTMCGltAiEfPDY_s3fnvG_qh4zesQoVc8Lo5LTmrKmFkw1tbpTzVirRM1bqe9WM8okxozJg-pBKeeU0k4xeb864I1mSgg9q77Ondtk67YkefIy2GVMZQqO9GmAQnzK5GSAOAW_DXFJ3tkp4KqQz2FakbPRQcadS0B8DFMoxMaB9Dmt4vcv3wrqFbAFSIhkWgH5CBPysZC59zbkQo7BjqjT2wzk_bZMsH5Y3fN2LPDoaj6szl6_-tAf16dv35z089PayYZOtWR8QQexkEKDb7QVthNd27R0kI4xrjBkGHcL6hXvtOJaeiEsFZQPXisQh9WLve7FZrGGwWFR2Y7mIoe1zVuTbDC3T2JYmWW6NLKjirUNCjy7Esjp0wbKZNahOBhHGyFtimFdwzn2WMn_o61kncb_1Ig-_QM9T5scsRM_KSxb6-Y3tbQjmBB9wie6naiZK8Z3N3OO1NFfKBwDrINLEXzA_VsJbJ_gciolg79uB6Nm5zez95tBv5md34zCnCc3-3id8ctgCPA9UPAoLiHfqOifqj8ACqbfeQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1561612884</pqid></control><display><type>article</type><title>Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hou, Jason K. ; Tan, Mimi ; Stidham, Ryan W. ; Colozzi, John ; Adams, Devon ; El-Serag, Hashem ; Waljee, Akbar K.</creator><creatorcontrib>Hou, Jason K. ; Tan, Mimi ; Stidham, Ryan W. ; Colozzi, John ; Adams, Devon ; El-Serag, Hashem ; Waljee, Akbar K.</creatorcontrib><description>Background
International Classification of Diseases-9 (ICD-9) codes are useful in clinical research; however, the validity of ICD-9 codes for inflammatory bowel disease (IBD) patients in multiple centers in the Veterans Affairs Health Care Systems (VA) has not been established. Our aim was to determine the accuracy of ICD-9 codes for Crohn’s disease (CD) and ulcerative colitis (UC) in the VA.
Methods
Patients with a diagnosis of IBD during 1999–2009 were identified by at least one ICD-9 code for CD (555.x) or UC (556.x) at the Houston and Ann Arbor VA Medical Centers and confirmed by chart review. A diagnosis of CD, UC, and IBD, unspecified (IBDU) was determined based on structured review of data in the VA medical records. Positive predictive values (PPV) were calculated for the codes using previously published ICD-9 algorithms.
Results
A total of 1,871 patients were identified with ICD-9 codes for IBD. Of these patients, 1,298 (69 %) were confirmed to have IBD, with 541 CD (41 %), 707 UC (55 %), and 50 IBDU (4 %) patients. An algorithm of 2 or more codes with at least one from an outpatient encounter improved the PPV (0.83 and 0.89 for CD and UC, respectively) compared a single code algorithm (PPV 0.59 and 0.66, respectively).
Conclusion
Single ICD-9 codes are inadequate to accurately define IBD patients; however, ICD-9 code algorithms can be used to identify patients with UC or CD with high positive predictive value. The
2 code, at least 1 outpatient
code algorithm was observed to have a high PPV and low miss rate.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-014-3174-7</identifier><identifier>PMID: 24817338</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Algorithms ; Biochemistry ; Cohort Studies ; Colitis ; Colitis, Ulcerative - classification ; Colitis, Ulcerative - diagnosis ; Crohn Disease - classification ; Crohn Disease - diagnosis ; Female ; Gastroenterology ; Gastrointestinal diseases ; Hepatology ; Humans ; International Classification of Diseases - standards ; Male ; Medical centers ; Medical colleges ; Medical records ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Oncology ; Original Article ; Pneumoviridae ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Transplant Surgery ; United States ; United States Department of Veterans Affairs</subject><ispartof>Digestive diseases and sciences, 2014-10, Vol.59 (10), p.2406-2410</ispartof><rights>Springer Science+Business Media New York (Outside the USA) 2014</rights><rights>COPYRIGHT 2014 Springer</rights><rights>Springer Science+Business Media New York 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c640t-612b0d3b638ef48a3a9395450d6c112754510d69b0f72987286f33a0302df87e3</citedby><cites>FETCH-LOGICAL-c640t-612b0d3b638ef48a3a9395450d6c112754510d69b0f72987286f33a0302df87e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-014-3174-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-014-3174-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24817338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hou, Jason K.</creatorcontrib><creatorcontrib>Tan, Mimi</creatorcontrib><creatorcontrib>Stidham, Ryan W.</creatorcontrib><creatorcontrib>Colozzi, John</creatorcontrib><creatorcontrib>Adams, Devon</creatorcontrib><creatorcontrib>El-Serag, Hashem</creatorcontrib><creatorcontrib>Waljee, Akbar K.</creatorcontrib><title>Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
International Classification of Diseases-9 (ICD-9) codes are useful in clinical research; however, the validity of ICD-9 codes for inflammatory bowel disease (IBD) patients in multiple centers in the Veterans Affairs Health Care Systems (VA) has not been established. Our aim was to determine the accuracy of ICD-9 codes for Crohn’s disease (CD) and ulcerative colitis (UC) in the VA.
Methods
Patients with a diagnosis of IBD during 1999–2009 were identified by at least one ICD-9 code for CD (555.x) or UC (556.x) at the Houston and Ann Arbor VA Medical Centers and confirmed by chart review. A diagnosis of CD, UC, and IBD, unspecified (IBDU) was determined based on structured review of data in the VA medical records. Positive predictive values (PPV) were calculated for the codes using previously published ICD-9 algorithms.
Results
A total of 1,871 patients were identified with ICD-9 codes for IBD. Of these patients, 1,298 (69 %) were confirmed to have IBD, with 541 CD (41 %), 707 UC (55 %), and 50 IBDU (4 %) patients. An algorithm of 2 or more codes with at least one from an outpatient encounter improved the PPV (0.83 and 0.89 for CD and UC, respectively) compared a single code algorithm (PPV 0.59 and 0.66, respectively).
Conclusion
Single ICD-9 codes are inadequate to accurately define IBD patients; however, ICD-9 code algorithms can be used to identify patients with UC or CD with high positive predictive value. The
2 code, at least 1 outpatient
code algorithm was observed to have a high PPV and low miss rate.</description><subject>Algorithms</subject><subject>Biochemistry</subject><subject>Cohort Studies</subject><subject>Colitis</subject><subject>Colitis, Ulcerative - classification</subject><subject>Colitis, Ulcerative - diagnosis</subject><subject>Crohn Disease - classification</subject><subject>Crohn Disease - diagnosis</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastrointestinal diseases</subject><subject>Hepatology</subject><subject>Humans</subject><subject>International Classification of Diseases - standards</subject><subject>Male</subject><subject>Medical centers</subject><subject>Medical colleges</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pneumoviridae</subject><subject>Predictive Value of Tests</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Transplant Surgery</subject><subject>United States</subject><subject>United States Department of Veterans Affairs</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFks1uEzEQx1cIREPhAbggS1y4bPHHru29IEXLRytVAgnK1XK848TVxi72pig3noA7r8eTMCGltAiEfPDY_s3fnvG_qh4zesQoVc8Lo5LTmrKmFkw1tbpTzVirRM1bqe9WM8okxozJg-pBKeeU0k4xeb864I1mSgg9q77Ondtk67YkefIy2GVMZQqO9GmAQnzK5GSAOAW_DXFJ3tkp4KqQz2FakbPRQcadS0B8DFMoxMaB9Dmt4vcv3wrqFbAFSIhkWgH5CBPysZC59zbkQo7BjqjT2wzk_bZMsH5Y3fN2LPDoaj6szl6_-tAf16dv35z089PayYZOtWR8QQexkEKDb7QVthNd27R0kI4xrjBkGHcL6hXvtOJaeiEsFZQPXisQh9WLve7FZrGGwWFR2Y7mIoe1zVuTbDC3T2JYmWW6NLKjirUNCjy7Esjp0wbKZNahOBhHGyFtimFdwzn2WMn_o61kncb_1Ig-_QM9T5scsRM_KSxb6-Y3tbQjmBB9wie6naiZK8Z3N3OO1NFfKBwDrINLEXzA_VsJbJ_gciolg79uB6Nm5zez95tBv5md34zCnCc3-3id8ctgCPA9UPAoLiHfqOifqj8ACqbfeQ</recordid><startdate>20141001</startdate><enddate>20141001</enddate><creator>Hou, Jason K.</creator><creator>Tan, Mimi</creator><creator>Stidham, Ryan W.</creator><creator>Colozzi, John</creator><creator>Adams, Devon</creator><creator>El-Serag, Hashem</creator><creator>Waljee, Akbar K.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20141001</creationdate><title>Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System</title><author>Hou, Jason K. ; Tan, Mimi ; Stidham, Ryan W. ; Colozzi, John ; Adams, Devon ; El-Serag, Hashem ; Waljee, Akbar K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c640t-612b0d3b638ef48a3a9395450d6c112754510d69b0f72987286f33a0302df87e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Algorithms</topic><topic>Biochemistry</topic><topic>Cohort Studies</topic><topic>Colitis</topic><topic>Colitis, Ulcerative - classification</topic><topic>Colitis, Ulcerative - diagnosis</topic><topic>Crohn Disease - classification</topic><topic>Crohn Disease - diagnosis</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastrointestinal diseases</topic><topic>Hepatology</topic><topic>Humans</topic><topic>International Classification of Diseases - standards</topic><topic>Male</topic><topic>Medical centers</topic><topic>Medical colleges</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pneumoviridae</topic><topic>Predictive Value of Tests</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Transplant Surgery</topic><topic>United States</topic><topic>United States Department of Veterans Affairs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hou, Jason K.</creatorcontrib><creatorcontrib>Tan, Mimi</creatorcontrib><creatorcontrib>Stidham, Ryan W.</creatorcontrib><creatorcontrib>Colozzi, John</creatorcontrib><creatorcontrib>Adams, Devon</creatorcontrib><creatorcontrib>El-Serag, Hashem</creatorcontrib><creatorcontrib>Waljee, Akbar K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hou, Jason K.</au><au>Tan, Mimi</au><au>Stidham, Ryan W.</au><au>Colozzi, John</au><au>Adams, Devon</au><au>El-Serag, Hashem</au><au>Waljee, Akbar K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2014-10-01</date><risdate>2014</risdate><volume>59</volume><issue>10</issue><spage>2406</spage><epage>2410</epage><pages>2406-2410</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>Background
International Classification of Diseases-9 (ICD-9) codes are useful in clinical research; however, the validity of ICD-9 codes for inflammatory bowel disease (IBD) patients in multiple centers in the Veterans Affairs Health Care Systems (VA) has not been established. Our aim was to determine the accuracy of ICD-9 codes for Crohn’s disease (CD) and ulcerative colitis (UC) in the VA.
Methods
Patients with a diagnosis of IBD during 1999–2009 were identified by at least one ICD-9 code for CD (555.x) or UC (556.x) at the Houston and Ann Arbor VA Medical Centers and confirmed by chart review. A diagnosis of CD, UC, and IBD, unspecified (IBDU) was determined based on structured review of data in the VA medical records. Positive predictive values (PPV) were calculated for the codes using previously published ICD-9 algorithms.
Results
A total of 1,871 patients were identified with ICD-9 codes for IBD. Of these patients, 1,298 (69 %) were confirmed to have IBD, with 541 CD (41 %), 707 UC (55 %), and 50 IBDU (4 %) patients. An algorithm of 2 or more codes with at least one from an outpatient encounter improved the PPV (0.83 and 0.89 for CD and UC, respectively) compared a single code algorithm (PPV 0.59 and 0.66, respectively).
Conclusion
Single ICD-9 codes are inadequate to accurately define IBD patients; however, ICD-9 code algorithms can be used to identify patients with UC or CD with high positive predictive value. The
2 code, at least 1 outpatient
code algorithm was observed to have a high PPV and low miss rate.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24817338</pmid><doi>10.1007/s10620-014-3174-7</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Digestive diseases and sciences, 2014-10, Vol.59 (10), p.2406-2410 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Algorithms Biochemistry Cohort Studies Colitis Colitis, Ulcerative - classification Colitis, Ulcerative - diagnosis Crohn Disease - classification Crohn Disease - diagnosis Female Gastroenterology Gastrointestinal diseases Hepatology Humans International Classification of Diseases - standards Male Medical centers Medical colleges Medical records Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Oncology Original Article Pneumoviridae Predictive Value of Tests Reproducibility of Results Retrospective Studies Sensitivity and Specificity Transplant Surgery United States United States Department of Veterans Affairs |
| title | Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System |
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