Validation of coding algorithms for the identification of patients hospitalized for alcoholic hepatitis using administrative data.

Background: Epidemiologic studies of alcoholic hepatitis (AH) have been hindered by the lack of a validated International Classification of Disease (ICD) coding algorithm for use with administrative data. Our objective was to validate coding algorithms for AH using a hospitalization database.Methods...

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Published in:BMC Gastroenterology Vol. 15; no. 1; pp. 1 - 9
Main Authors: Jack XQ Pang, Ross, Erin, Borman, Meredith A., Zimmer, Scott, Kaplan, Gilaad G., Heitman, Steven J., Swain, Mark G., Burak, Kelly W., Hude Quan, Myers, Robert P., Pang, Jack Xq, Quan, Hude, Pang, Jack X Q
Format: research Journal Article
Published: BioMed Central 9/12/2015
Online Access:View this record in EBSCOhost
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      dt: 9/12/2015
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      pub: BioMed Central
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        atl: Validation of coding algorithms for the identification of patients hospitalized for alcoholic hepatitis using administrative data.
      aug:
        au:
          Jack XQ Pang
          Ross, Erin
          Borman, Meredith A.
          Zimmer, Scott
          Kaplan, Gilaad G.
          Heitman, Steven J.
          Swain, Mark G.
          Burak, Kelly W.
          Hude Quan
          Myers, Robert P.
          Pang, Jack Xq
          Quan, Hude
          Pang, Jack X Q
        affil: Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada
      sug:
        subj:
          Information Retrieval Methods
          Coding
          Hepatitis, Alcoholic Diagnosis
          Algorithms
          Resource Databases Standards
          Hepatitis, Alcoholic Epidemiology
          International Classification of Diseases
          Female
          Epidemiological Research
          Alberta
          Medical Records
          Retrospective Design
          Patient Discharge
          Adult
          Male
          Gastrointestinal Hemorrhage Epidemiology
          Gastrointestinal Hemorrhage Diagnosis
          Ascites Epidemiology
          Middle Age
          Liver Cirrhosis Epidemiology
          Human
          Ascites Diagnosis
          Predictive Value of Tests
          Liver Cirrhosis Diagnosis
          Prevalence
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Epidemiologic studies of alcoholic hepatitis (AH) have been hindered by the lack of a validated International Classification of Disease (ICD) coding algorithm for use with administrative data. Our objective was to validate coding algorithms for AH using a hospitalization database.Methods: The Hospital Discharge Abstract Database (DAD) was used to identify consecutive adults (≥18 years) hospitalized in the Calgary region with a diagnosis code for AH (ICD-10, K70.1) between 01/2008 and 08/2012. Medical records were reviewed to confirm the diagnosis of AH, defined as a history of heavy alcohol consumption, elevated AST and/or ALT (<300 U/L), serum bilirubin >34 μmol/L, and elevated INR. Subgroup analyses were performed according to the diagnosis field in which the code was recorded (primary vs. secondary) and AH severity. Algorithms that incorporated ICD-10 codes for cirrhosis and its complications were also examined.Results: Of 228 potential AH cases, 122 patients had confirmed AH, corresponding to a positive predictive value (PPV) of 54% (95% CI 47-60%). PPV improved when AH was the primary versus a secondary diagnosis (67% vs. 21%; P < 0.001). Algorithms that included diagnosis codes for ascites (PPV 75%; 95% CI 63-86%), cirrhosis (PPV 60%; 47-73%), and gastrointestinal hemorrhage (PPV 62%; 51-73%) had improved performance, however, the prevalence of these diagnoses in confirmed AH cases was low (29-39%).Conclusions: In conclusion the low PPV of the diagnosis code for AH suggests that caution is necessary if this hospitalization database is used in large-scale epidemiologic studies of this condition.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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