国际疾病分类的有效性，第十次修订，肝硬化守则

StephenW

Validity of International Classification of Diseases, 10th Revision, Codes for Cirrhosis
Nathan S Ramrakhiani, Michael Le, Yee Hui Yeo, An Le, Mayumi Maeda, Mindie H Nguyen

    PMID: 32814313 DOI: 10.1159/000510981

Abstract

Introduction: Accurate identification of patients with cirrhosis is important for research using administrative databases. We aimed to examine the accuracy of several major ICD-10 codes for cirrhosis diagnosis in a large and diverse patient cohort; there is little existing research on this topic.

Methods: Using data from 3396 patients with chronic liver disease (hepatitis B, C or non-alcoholic fatty liver disease) from one university and several community medical centers, we calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC) for several major ICD-10 codes for cirrhosis, which was verified by individual chart review. We performed a secondary validation in a general cohort of 1560 randomly selected patients.

Results: While each of the individual study ICD-10 codes were specific (98.08 - 100%), none of the codes were sufficiently sensitive (0.27 - 55.70%). PPVs were high in the chronic liver disease cohort (88.41 - 100%) but lower in the general population (55.53 - 66.76%). The AUROC for having at least one code was higher (0.79) than any code alone (0.50 - 0.65).

Discussion/conclusion: Individual ICD-10 codes are suboptimal for identifying patients with cirrhosis in the general patient population. We recommend conditioning ICD-10 code searches with a chronic liver disease diagnosis code and/or combining diagnostic codes to maximize performance.

© 2020 S. Karger AG, Basel.

StephenW

国际疾病分类的有效性，第十次修订，肝硬化守则
Nathan S Ramrakhiani，Michael Le，Ye Hui Yeo，An Le，Mayumi Maeda，Mindie H Nguyen

    PMID：32814313 DOI：10.1159 / 000510981

抽象

简介：准确识别肝硬化患者对于使用行政数据库进行研究非常重要。我们的目的是在大量不同的患者队列中检查几种主要的ICD-10肝硬化诊断代码的准确性。关于此主题的现有研究很少。

方法：使用来自一所大学和几个社区医学中心的3396例慢性肝病（乙型，丙型肝炎或非酒精性脂肪肝病）患者的数据，我们计算出敏感性，特异性，阳性预测值（PPV），阴性预测值（ NPV）和几个主要的ICD-10肝硬化代码的接收器工作特性曲线下面积（AUROC），已通过单独的图表审查得到了验证。我们在1560名随机选择的患者的一般队列中进行了二次验证。

结果：尽管每个单独的研究ICD-10代码都是特定的（98.08-100％），但没有一个代码足够敏感（0.27-55.70％）。 PPV在慢性肝病队列中较高（88.41-100％），但在一般人群中较低（55.53-66.76％）。具有至少一个代码的AUROC（0.79）比任何单独代码（0.50-0.65）高。

讨论/结论：单独的ICD-10代码在识别一般患者人群中的肝硬化患者方面不理想。我们建议使用慢性肝病诊断代码和/或组合诊断代码来限制ICD-10代码搜索，以实现最佳性能。

©2020 S.Karger AG，巴塞尔。

nana2ferrari

说的是啥意思 ？