School of Public Health, University of Alberta, 650 University Terrace, Edmonton, AB, T6G 2T4, Canada.
BMC Med Res Methodol. 2011 Dec 21;11:173. doi: 10.1186/1471-2288-11-173.
Administrative health databases are a valuable research tool to assess health care utilization at the population level. However, their use in obesity research limited due to the lack of data on body weight. A potential workaround is to use the ICD code of obesity to identify obese individuals. The objective of the current study was to investigate the sensitivity and specificity of an ICD code-based diagnosis of obesity from administrative health data relative to the gold standard measured BMI.
Linkage of a population-based survey with anthropometric measures in elementary school children in 2003 with longitudinal administrative health data (physician visits and hospital discharges 1992-2006) from the Canadian province of Nova Scotia. Measured obesity was defined based on the CDC cut-offs applied to the measured BMI. An ICD code-based diagnosis obesity was defined as one or more ICD-9 (278) or ICD-10 code (E66-E68) of obesity from a physician visit or a hospital stay. Sensitivity and specificity were calculated and health care cost estimates based on measured obesity and ICD-based obesity were compared.
The sensitivity of an ICD code-based obesity diagnosis was 7.4% using ICD codes between 2002 and 2004. Those correctly identified had a higher BMI and had higher health care utilization and costs.
An ICD diagnosis of obesity in Canadian administrative health data grossly underestimates the true prevalence of childhood obesity and overestimates the health care cost differential between obese and non-obese children.
行政健康数据库是评估人群健康服务利用情况的一种有价值的研究工具。然而，由于缺乏体重数据，它们在肥胖研究中的应用受到限制。一种潜在的解决方法是使用肥胖的 ICD 代码来识别肥胖个体。本研究的目的是调查基于 ICD 代码的肥胖诊断与金标准测量 BMI 相比的敏感性和特异性。
将基于人群的调查与 2003 年小学生的人体测量数据进行链接，并与加拿大新斯科舍省的纵向行政健康数据（1992-2006 年的医生就诊和住院记录）进行链接。根据适用于测量 BMI 的 CDC 切点，将肥胖定义为基于测量的肥胖。基于 ICD 代码的肥胖诊断是指医生就诊或住院期间的一个或多个 ICD-9（278）或 ICD-10 代码（E66-E68）的肥胖。计算了敏感性和特异性，并比较了基于测量的肥胖和基于 ICD 的肥胖的医疗保健费用估计。
2002 年至 2004 年期间，ICD 代码的肥胖诊断敏感性为 7.4%。正确识别的患者 BMI 更高，医疗保健利用率和费用更高。
加拿大行政健康数据中基于 ICD 的肥胖诊断严重低估了儿童肥胖的真实患病率，并高估了肥胖和非肥胖儿童之间的医疗保健费用差异。
