ICD-9-CM 编码在行政数据中识别肺炎和单纯疱疹病毒感染的准确性。
Accuracy of ICD-9-CM codes in identifying infections of pneumonia and herpes simplex virus in administrative data.
机构信息
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20852-7234, USA.
出版信息
Ann Epidemiol. 2013 May;23(5):291-3. doi: 10.1016/j.annepidem.2013.02.005. Epub 2013 Mar 22.
PURPOSE
Clinical epidemiology studies increasingly rely on electronic medical records data. The validity of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes is crucial as they are often used to identify conditions of interest. We evaluated the use of archived ICD-9-CM codes to identify two representative infection-related conditions, pneumonia and herpes simplex virus (HSV), in a defined health system.
METHODS
Records were obtained for a sample of 175 and 179 patients with ICD-9-CM codes for pneumonia and HSV, respectively. An adjudicated case status was assigned for each subject.
RESULTS
The presence of a single ICD-9-CM code had a positive predictive value of 88% for pneumonia and 86% for HSV. False positives (noncases) accounted for less than 10% of records evaluated for each condition.
CONCLUSIONS
Our study demonstrates that ICD-9-CM codes for pneumonia and HSV were valid markers of a true history of these conditions, suggesting that ICD-9-CM codes can be used to successfully identify infection-related conditions in epidemiologic studies. However, validation studies for individual conditions may help identify condition-specific strategies to improve the performance of diagnostic codes.
目的
临床流行病学研究越来越依赖电子病历数据。国际疾病分类，第 9 修订版，临床修正（ICD-9-CM）诊断代码的有效性至关重要，因为它们通常用于识别相关疾病。我们评估了使用存档的 ICD-9-CM 代码来识别特定医疗系统中的两种具有代表性的感染相关疾病，肺炎和单纯疱疹病毒（HSV）。
方法
分别对肺炎和 HSV 的 ICD-9-CM 代码各 175 例和 179 例患者的记录进行了抽样。为每个对象分配了一个经裁决的病例状态。
结果
单个 ICD-9-CM 代码的存在对肺炎的阳性预测值为 88%，对 HSV 的阳性预测值为 86%。对于每种疾病，评估的记录中假阳性（非病例）不到 10%。
结论
我们的研究表明，肺炎和 HSV 的 ICD-9-CM 代码是这些疾病真实病史的有效标志物，表明 ICD-9-CM 代码可用于成功识别流行病学研究中的感染相关疾病。但是，针对个别疾病的验证研究可能有助于确定特定于疾病的策略来提高诊断代码的性能。
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