Sheu Ming-Jen, Liang Fu-Weng, Li Sheng-Tun, Li Chung-Yi, Lu Tsung-Hsueh
Division of Gastroenterology and Hepatology, Chi Mei Medical Center, Tainan, Taiwan.
Department of Medicinal Chemistry, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Clin Epidemiol. 2020 Feb 20;12:185-192. doi: 10.2147/CLEP.S236823. eCollection 2020.
To validate the use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the Taiwan National Health Insurance (NHI) Outpatient Claims Dataset.
We conducted a retrospective study using results of HBV surface antigen (HBsAg), HBV e antigen (HBeAg), and anti-HCV antibody tests in the NHI Lab & Exam Dataset from January 1 to March 31, 2018, as the reference standard to confirm HBV and HCV infection cases. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to assess the performance of HBV infection-specific ICD-10-CM codes (B180, B181, and B191) and HCV infection-specific ICD-10-CM codes (B182 and B192) recorded in the NHI Outpatient Claims Dataset to identify patients with HBV or HCV infection.
In total, 196,635 and 120,628 patients had analyzable results for HBsAg/HBeAg tests and anti-HCV tests, respectively. Moreover, 44,574 and 14,443 were confirmed to have HBV and HCV infection, respectively. The sensitivity, specificity, PPV, and NPV were, respectively, 46%, 83%, 45%, and 84% for HBV infection-specific ICD-10-CM codes and 47%, 99%, 81%, and 93% for HCV infection-specific ICD-10-CM codes. The sensitivity demonstrated great variation by region, clinical setting, and physician specialty.
The HBV and HCV infection-specific ICD-10-CM codes recorded by physicians in Taiwan NHI outpatient claims data in 2018 had moderate sensitivity and high specificity for both HBV and HCV infection. The PPV was high for HCV ICD-10-CM codes, yet moderate for HBV ICD-10-CM codes.
验证在台湾国民健康保险（NHI）门诊理赔数据集中，使用国际疾病分类第十次修订版临床修正本（ICD - 10 - CM）编码来识别慢性乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染患者的情况。
我们进行了一项回顾性研究，将2018年1月1日至3月31日NHI实验室与检查数据集中HBV表面抗原（HBsAg）、HBV e抗原（HBeAg）和抗HCV抗体检测结果作为确认HBV和HCV感染病例的参考标准。我们计算了敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV），以评估NHI门诊理赔数据集中记录的HBV感染特异性ICD - 10 - CM编码（B180、B181和B191）和HCV感染特异性ICD - 10 - CM编码（B182和B192）识别HBV或HCV感染患者的性能。
总共有196,635名和120,628名患者分别有可分析的HBsAg/HBeAg检测结果和抗HCV检测结果。此外，分别有44,574名和14,443名患者被确诊为HBV和HCV感染。HBV感染特异性ICD - 10 - CM编码的敏感性、特异性、PPV和NPV分别为46%、83%、45%和84%，HCV感染特异性ICD - 10 - CM编码的相应数值分别为47%、99%、81%和93%。敏感性在地区、临床环境和医生专业方面表现出很大差异。
2018年台湾NHI门诊理赔数据中医生记录的HBV和HCV感染特异性ICD - 10 - CM编码对HBV和HCV感染均具有中等敏感性和高特异性。HCV的ICD - 10 - CM编码的PPV较高，而HBV的ICD - 10 - CM编码的PPV中等。
