基于诊断和外部病因的标准，用于识别医院ICD编码数据中的药物不良反应：应用于澳大利亚基于人群的研究。

Diagnosis-based and external cause-based criteria to identify adverse drug reactions in hospital ICD-coded data: application to an Australia population-based study.

作者信息

Du Wei, Pearson Sallie-Anne, Buckley Nicholas A, Day Cathy, Banks Emily

机构信息

National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT,

Faculty of Pharmacy, University of Sydney, NSW, Australia.

出版信息

Public Health Res Pract. 2017 Apr 27;27(2):2721716. doi: 10.17061/phrp2721716.

DOI:10.17061/phrp2721716

PMID:28474053

Abstract

OBJECTIVES

External cause International Classification of Diseases (ICD) codes are commonly used to ascertain adverse drug reactions (ADRs) related to hospitalisation. We quantified ascertainment of ADR-related hospitalisation using external cause codes and additional ICD-based hospital diagnosis codes.

METHODS

We reviewed the scientific literature to identify different ICD-based criteria for ADR-related hospitalisations, developed algorithms to capture ADRs based on candidate hospital ICD-10 diagnoses and external cause codes (Y40-Y59), and incorporated previously published causality ratings estimating the probability that a specific diagnosis was ADR related. We applied the algorithms to the NSW Admitted Patient Data Collection records of 45 and Up Study participants (2011-2013).

RESULTS

Of 493 442 hospitalisations among 267 153 study participants during 2011-2013, 18.8% (n = 92 953) had hospital diagnosis codes that were potentially ADR related; 1.1% (n = 5305) had high/very high-probability ADR-related diagnosis codes (causality ratings: A1 and A2); and 2.0% (n = 10 039) had ADR-related external cause codes. Overall, 2.2% (n = 11 082) of cases were classified as including an ADR-based hospitalisation on either external cause codes or high/very high-probability ADR-related diagnosis codes. Hence, adding high/very high-probability ADR-related hospitalisation codes to standard external cause codes alone (Y40-Y59) increased the number of hospitalisations classified as having an ADR-related diagnosis by 10.4%. Only 6.7% of cases with high-probability ADR-related mental symptoms were captured by external cause codes.

CONCLUSION

Selective use of high-probability ADR-related hospital diagnosis codes in addition to external cause codes yielded a modest increase in hospitalised ADR incidence, which is of potential clinical significance. Clinically validated combinations of diagnosis codes could potentially further enhance capture.

摘要

目的

国际疾病分类（ICD）外部病因编码常用于确定与住院相关的药物不良反应（ADR）。我们使用外部病因编码和基于ICD的其他住院诊断编码对ADR相关住院情况进行了量化。

方法

我们查阅了科学文献，以确定基于ICD的ADR相关住院的不同标准，开发了基于候选医院ICD-10诊断和外部病因编码（Y40-Y59）来捕捉ADR的算法，并纳入了先前发表的因果关系评级，以估计特定诊断与ADR相关的概率。我们将这些算法应用于新南威尔士州45岁及以上研究参与者的住院患者数据收集记录（2011-2013年）。

结果

在2011-2013年期间，267153名研究参与者中的493442次住院中，18.8%（n = 92953）的住院诊断编码可能与ADR相关；1.1%（n = 5305）有高/非常高概率的ADR相关诊断编码（因果关系评级：A1和A2）；2.0%（n = 10039）有与ADR相关的外部病因编码。总体而言，2.2%（n = 11082）的病例被归类为基于外部病因编码或高/非常高概率的ADR相关诊断编码的与ADR相关的住院。因此，仅将高/非常高概率的ADR相关住院编码添加到标准外部病因编码（Y40-Y59）中，将被归类为有ADR相关诊断的住院次数增加了10.4%。外部病因编码仅捕捉到6.7%有高概率ADR相关精神症状的病例。