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安大略省健康管理数据库中血管内和开放胸腹主动脉瘤修复的验证。

Validation of endovascular and open thoracoabdominal aortic aneurysm repair in Ontario health administrative databases.

机构信息

Division of Cardiac Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto.

出版信息

Clin Invest Med. 2019 Jun 23;42(2):E19-25. doi: 10.25011/cim.v42i2.32812.

Abstract

PURPOSE

The positive predictive value (PPV) of endovascular and open thoracoabdominal aortic aneurysm (TAAA) repair coding was assessed in Ontario health administrative databases.

METHODS

Between 1 January 2006 and 31 March 2016, a random sample of 192 patients was identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. Blinded chart reviews were conducted at two cardiovascular centers to assess the level of agreement between the administrative records and the corresponding patients' hospital charts. The PPV was calculated with 95% confidence intervals using hospital charts as the gold standard.

RESULTS

The PPV for the single endovascular TAAA repair code, 1ID80GQNRN, was 0.90 (0.78, 0.97). A combination of all nine CCI open TAAA repair codes was performed, with a PPV of 0.62 (0.47, 0.76). The combination of any one of the nine CCI codes AND the single OHIP code for open TAAA repair (R803) rendered a PPV of 0.98 (0.90, 1.00).

CONCLUSIONS

Endovascular TAAA repair may be identified using a single CCI code (1ID80GQNRN). Open TAAA repair may be identified using a combination of CCI and OHIP codes. Researchers may therefore use administrative data to conduct population-based studies of endovascular and open repair of TAAA.

摘要

目的

在安大略省卫生管理数据库中评估血管内和开放胸腹主动脉瘤(TAAA)修复编码的阳性预测值(PPV)。

方法

在 2006 年 1 月 1 日至 2016 年 3 月 31 日期间,使用加拿大卫生干预分类(CCI)程序代码和安大略省健康保险计划(OHIP)计费代码,从管理数据中随机抽取了 192 名患者。在两个心血管中心进行了盲法图表审查,以评估管理记录与相应患者病历之间的一致性程度。使用病历作为金标准,通过 95%置信区间计算 PPV。

结果

单一血管内 TAAA 修复代码 1ID80GQNRN 的 PPV 为 0.90(0.78,0.97)。使用所有九个 CCI 开放 TAAA 修复代码的组合,PPV 为 0.62(0.47,0.76)。任何一个 CCI 代码和开放 TAAA 修复的单个 OHIP 代码(R803)的组合的 PPV 为 0.98(0.90,1.00)。

结论

血管内 TAAA 修复可以使用单个 CCI 代码(1ID80GQNRN)进行识别。开放 TAAA 修复可以使用 CCI 和 OHIP 代码的组合进行识别。因此,研究人员可以使用管理数据来进行 TAAA 的血管内和开放修复的基于人群的研究。

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