基于国际疾病分类第 10 版代码的胰腺癌行政数据库的准确性：一项回顾性大样本研究。
Accuracy of an administrative database for pancreatic cancer by international classification of disease 10 codes: A retrospective large-cohort study.
机构信息
Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea.
Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju 28644, South Korea.
出版信息
World J Gastroenterol. 2019 Oct 7;25(37):5619-5629. doi: 10.3748/wjg.v25.i37.5619.
BACKGROUND
Korean National Health Insurance (NHI) claims database provides large-cohort. However, studies regarding accuracy of administrative database for pancreatic cancer (PC) have not been reported. We aimed to identify accuracy of NHI database regarding PC classified by international classification of disease (ICD)-10 codes.
AIM
To identify the accuracy and usefulness of administrative database in PC and the accurate ICD codes for PC with location.
METHODS
Study and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital. Cases of PC were identified in NHI database by international classification of diseases, 10th revision edition (ICD-10 codes) supported with V codes. V code is issued by medical doctors for covering 95% of medical cost by Korean government. According to pathologic reports, definite or possible diagnoses were defined using medical records, images, and pathology.
RESULTS
A total of 1846 cases with PC and controls were collected. Among PC, only 410 (22.2%) cases were identified as specific cancer sites including head in 234 (12.7%) cases, tail in 104 (5.6%) cases and body in 72 (3.9%) cases. Among PC, 910 (49.3%) cases were diagnosed by definite criteria. Most of these were adenocarcinoma (98.0%). The rates of definite diagnosis of PC were highest in head (70.1%) followed by body (47.2%) and tail (43.3%). False-positive cases were pancreatic cystic neoplasm and metastasis to the pancreas. In terms of the overall diagnosis of PC, sensitivity, specificity, positive predictive value, and negative predictive value were 99.95%, 98.72%, 98.70%, and 99.95%, respectively. Diagnostic accuracy was similar both in terms of diagnostic criteria and tumor locations.
CONCLUSION
Korean NHI claims database collected according to ICD-10 code with V code for PC showed good accuracy.
背景
韩国国民健康保险（NHI）理赔数据库提供了大型队列。然而，关于使用国际疾病分类（ICD）-10 代码对胰腺癌（PC）进行管理的数据库的准确性的研究尚未报道。我们旨在确定 NHI 数据库对 PC 进行分类的准确性，以及用于 PC 位置的准确 ICD 代码。
目的
确定管理数据库在 PC 中的准确性和实用性，以及用于 PC 位置的准确 ICD 代码。
方法
研究组和对照组于 2003 年至 2016 年在首尔国立大学盆唐医院收集。NHI 数据库中的 PC 病例通过 ICD-10 代码确定，V 代码支持该代码。V 代码由医生开出，以覆盖韩国政府 95%的医疗费用。根据病理报告，使用病历、图像和病理学确定明确或可能的诊断。
结果
共收集了 1846 例 PC 病例和对照组。在 PC 中，仅有 410 例（22.2%）被确定为特定的癌症部位，其中 234 例（12.7%）为头部，104 例（5.6%）为尾部，72 例（3.9%）为体部。在 PC 中，910 例（49.3%）通过明确的标准进行诊断。这些病例大多数为腺癌（98.0%）。头部的明确诊断率最高（70.1%），其次是体部（47.2%）和尾部（43.3%）。假阳性病例为胰腺囊性肿瘤和胰腺转移。就 PC 的总体诊断而言，敏感性、特异性、阳性预测值和阴性预测值分别为 99.95%、98.72%、98.70%和 99.95%。在诊断标准和肿瘤部位方面，诊断准确性相似。
结论
根据 ICD-10 代码和用于 PC 的 V 代码收集的韩国 NHI 理赔数据库具有良好的准确性。
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