Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA.
Translational Research for Affordability and Quality, HealthCore, Inc., Wilmington, DE, USA.
Pharmacoepidemiol Drug Saf. 2018 Aug;27(8):839-847. doi: 10.1002/pds.4563. Epub 2018 Jun 26.
To describe the consistency in the frequency of 5 health outcomes across the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) eras in the US.
We examined the incidence of 3 acute conditions (acute myocardial infarction [AMI], angioedema, ischemic stroke) and the prevalence of 2 chronic conditions (diabetes, hypertension) during the final 5 years of the ICD-9-CM era (January 2010-September 2015) and the first 15 months of the ICD-10-CM era (October 2015-December 2016) in 13 electronic health care databases in the Sentinel System. For each health outcome reviewed during the ICD-10-CM era, we evaluated 4 definitions, including published algorithms derived from other countries, as well as simple-forward, simple-backward, and forward-backward mapping using the General Equivalence Mappings. For acute conditions, we also compared the incidence between April to December 2014 and April to December 2016.
The analyses included data from approximately 172 million health plan members. While the incidence or prevalence of AMI and hypertension performed similarly across the 2 eras, the other 3 outcomes did not demonstrate consistent trends for some or all the ICD-10-CM definitions assessed.
When using data from both the ICD-9-CM and ICD-10-CM eras, or when using results from ICD-10-CM data to compare to results from ICD-9-CM data, researchers should test multiple ICD-10-CM outcome definitions as part of sensitivity analysis. Ongoing assessment of the impact of ICD-10-CM transition on identification of health outcomes in US electronic health care databases should occur as more data accrue.
描述美国国际疾病分类第 9 版临床修订本（ICD-9-CM）和第 10 版临床修订本（ICD-10-CM）时代 5 种健康结局的频率一致性。
我们在 Sentinel 系统的 13 个电子医疗保健数据库中，检查了 ICD-9-CM 时代最后 5 年（2010 年 1 月至 2015 年 9 月）和 ICD-10-CM 时代前 15 个月（2015 年 10 月至 2016 年 12 月）期间 3 种急性疾病（急性心肌梗死[AMI]、血管性水肿、缺血性中风）和 2 种慢性疾病（糖尿病、高血压）的发生率。对于在 ICD-10-CM 时代期间审查的每种健康结局，我们评估了 4 种定义，包括从其他国家衍生的已发表算法，以及使用通用等效映射的简单向前、简单向后和向前向后映射。对于急性疾病，我们还比较了 2014 年 4 月至 12 月和 2016 年 4 月至 12 月之间的发生率。
分析包括来自大约 1.72 亿医疗计划成员的数据。虽然 AMI 和高血压的发病率或患病率在两个时代都相似，但其他 3 种结局在某些或所有评估的 ICD-10-CM 定义中并未表现出一致的趋势。
当使用 ICD-9-CM 和 ICD-10-CM 时代的数据时，或者当使用 ICD-10-CM 数据的结果与 ICD-9-CM 数据的结果进行比较时，研究人员应该作为敏感性分析的一部分测试多种 ICD-10-CM 结局定义。随着更多数据的积累，应该持续评估 ICD-10-CM 转换对美国电子医疗保健数据库中健康结局识别的影响。
