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...
| Published in: | BMC Gastroenterology Vol. 15; no. 1; pp. 1 - 9 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
BioMed Central
9/12/2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109504704&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109504704 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1471230X 1CHO jtl: BMC Gastroenterology issn: 1471230X maglogo: N pubinfo: dt: 9/12/2015 vid: 15 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 109504704 109504704 NLM26362871 109504704 10.1186/s12876-015-0348-5 NLM26362871 PMC4566395 109504704 ppf: 1 ppct: 8 formats: tig: 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 refInfo: holdings: @attributes: islocal: N |
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