Department of Medicine, Miller School of Medicine at the University of Miami, Miami, FL 33136, USA.
Pharmacoepidemiol Drug Saf. 2012 Jan;21 Suppl 1:154-62. doi: 10.1002/pds.2341.
Venous thromboembolism (VTE) is a serious complication. Large claims databases can potentially identify the effects that medications have on VTE. The purpose of this study is to evaluate the evidence supporting the validity of VTE codes.
A search of MEDLINE database is supplemented by manual searches of bibliographies of key relevant articles. We selected all studies in which a claim code was validated against a medical record. We reported the positive predictive value (PPV) for the VTE claim compared to the medical record.
Our search strategy yielded 345 studies, of which only 19 met our eligibility criteria. All of the studies reported on ICD-9 codes, but only two studies reported on pharmacy codes, and one study reported on procedure codes. The highest PPV (65%-95%) was reported for the combined use of ICD-9 codes 415 (pulmonary embolism), 451, and 453 (deep vein thrombosis) as a VTE event. If a specific event like DVT (PPV 24%-92%) or PE (PPV 31%-97%) was evaluated, the PPV was lower than when the combined events were examined. Studies that included patients after orthopedic surgery reported the highest PPV (96%-100%).
The use of ICD-9 415, 451, and 453 are appropriate for the identification of VTE in claims databases. The codes performed best when codes were evaluated in patients at higher risk of VTE.
静脉血栓栓塞症（VTE）是一种严重的并发症。大型索赔数据库有可能确定药物对 VTE 的影响。本研究的目的是评估支持 VTE 代码有效性的证据。
对 MEDLINE 数据库进行搜索，并辅以关键相关文章的参考文献的手动搜索。我们选择了所有针对病历验证索赔代码的研究。我们报告了与病历相比 VTE 索赔的阳性预测值（PPV）。
我们的搜索策略产生了 345 项研究，其中只有 19 项符合我们的入选标准。所有研究均报告了 ICD-9 代码，但只有两项研究报告了药房代码，一项研究报告了程序代码。ICD-9 代码 415（肺栓塞）、451 和 453（深静脉血栓形成）联合使用的最高 PPV（65%-95%）报告了 VTE 事件。如果评估特定事件，如 DVT（PPV 24%-92%）或 PE（PPV 31%-97%），则低于联合检查时的 PPV。包括骨科手术后患者的研究报告了最高的 PPV（96%-100%）。
ICD-9 415、451 和 453 可用于在索赔数据库中识别 VTE。在 VTE 风险较高的患者中评估代码时，这些代码的效果最佳。
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