Chart validation of inpatient ICD-9-CM administrative diagnosis codes for ischemic stroke among IGIV users in the Sentinel Distributed Database.

The Sentinel Distributed Database (SDD) is a large database of patient-level medical and prescription records, primarily derived from insurance claims and electronic health records, and is sponsored by the U.S. Food and Drug Administration for drug safety assessments. In this chart validation study,...

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Published in:Medicine Vol. 96; no. 52; pp. 1 - 7
Main Authors: Ammann, Eric M., Leira, Enrique C., Winiecki, Scott K., Nagaraja, Nandakumar, Dandapat, Sudeepta, Carnahan, Ryan M., Schweizer, Marin L., Torner, James C., Fuller, Candace C., Leonard, Charles E., Garcia, Crystal, Pimentel, Madelyn, Chrischilles, Elizabeth A.
Format: research tables/charts Journal Article
Published: Lippincott Williams & Wilkins 12/29/2017
Online Access:View this record in EBSCOhost
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      dt: 12/29/2017
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      pub: Lippincott Williams & Wilkins
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        atl: Chart validation of inpatient ICD-9-CM administrative diagnosis codes for ischemic stroke among IGIV users in the Sentinel Distributed Database.
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        au:
          Ammann, Eric M.
          Leira, Enrique C.
          Winiecki, Scott K.
          Nagaraja, Nandakumar
          Dandapat, Sudeepta
          Carnahan, Ryan M.
          Schweizer, Marin L.
          Torner, James C.
          Fuller, Candace C.
          Leonard, Charles E.
          Garcia, Crystal
          Pimentel, Madelyn
          Chrischilles, Elizabeth A.
        affil: College of Public Health, University of Iowa, Iowa City, IA
      sug:
        subj:
          Immunologic Factors Therapeutic Use
          Immunoglobulins, Intravenous Therapeutic Use
          Cerebral Ischemia Diagnosis
          Hospitalization
          International Classification of Diseases
          Stroke Diagnosis
          Predictive Value of Tests
          Middle Age
          Aged
          Young Adult
          Female
          Adult
          Child
          Infant, Newborn
          United States
          Male
          Aged, 80 and Over
          Resource Databases
          Adolescence
          Infant
          Child, Preschool
          Human
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Child: 6-12 years
          Infant, Newborn: birth-1 month
          Aged, 80 & over
          Adolescent: 13-18 years
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Female
          Male
      ab: The Sentinel Distributed Database (SDD) is a large database of patient-level medical and prescription records, primarily derived from insurance claims and electronic health records, and is sponsored by the U.S. Food and Drug Administration for drug safety assessments. In this chart validation study, we report on the positive predictive value (PPV) of inpatient ICD-9-CM acute ischemic stroke (AIS) administrative diagnosis codes (433.x1, 434.xx, and 436) in the SDD.As part of an assessment of the risk of thromboembolic adverse events following treatment with intravenous immune globulin (IGIV), charts were obtained for 131 potential post-IGIV AIS cases. Charts were abstracted by trained nurses and then adjudicated by stroke experts using pre-specified diagnostic criteria.Case status could be determined for 128 potential AIS cases, of which 34 were confirmed. The PPVs for the inpatient AIS diagnoses recorded in the SDD were 27% overall [95% confidence interval (95% CI): 19-35], 60% (95% CI: 32-84) for principal-position diagnoses, 42% (95% CI: 28-57) for secondary diagnoses, and 6% (95% CI: 2-15) for position-unspecified diagnoses (which in the SDD generally originate from separate physician claims associated with an inpatient stay).Position-unspecified diagnoses were unlikely to represent true AIS cases. PPVs for principal and secondary inpatient diagnosis codes were higher, but still meaningfully lower than estimates from prior chart validation studies. The low PPVs may be specific to the IGIV user study population. Additional research is needed to assess the validity of AIS administrative diagnosis codes in other study populations within the SDD.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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