Liao Shu-Chen, Shao Shih-Chieh, Lai Edward Chia-Cheng, Lin Swu-Jane, Huang Wei-I, Hsieh Cheng-Yang
Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Chang Gung University College of Medicine, Taoyuan, Taiwan.
Clin Epidemiol. 2022 Jan 3;14:1-7. doi: 10.2147/CLEP.S335517. eCollection 2022.
This study aims to determine the positive predictive value (PPV) of case definitions for cerebral venous sinus thrombosis (CVST) in Taiwan's National Health Insurance claims database based on the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnostic codes.
Inpatient records with ICD-10-CM codes of G08, I629, I636, or I676 were retrieved from the claims data of all hospital branches of Chang Gung Medical Foundation. Manual review of the medical records and images was performed in order to ascertain the diagnosis. The PPV of various case definitions for CVST was estimated.
Of the 380 hospitalizations, 166 and 214 were determined to be true-positive and false-positive episodes of acute CVST, respectively. The PPV of the ICD-10-CM codes of G08, I629, I636, and I676 was 88.2%, 2.0%, 100.0%, and 91.3%, respectively. The PPV generally increased when acute CVST was defined as a primary diagnosis or as ICD-10-CM codes plus anticoagulant use. Miscoding in other conditions, tentative diagnosis, and remote episode of CVST were determined as the main reasons for false-positive diagnosis of acute CVST.
This study determined the PPV of ICD-10-CM codes for identifying CVST, which may offer a reference for future claims-based research.
本研究旨在基于国际疾病分类第十版临床修订本(ICD - 10 - CM)诊断编码,确定台湾地区国民健康保险理赔数据库中脑静脉窦血栓形成(CVST)病例定义的阳性预测值(PPV)。
从长庚医疗基金会所有医院分院的理赔数据中检索出ICD - 10 - CM编码为G08、I629、I636或I676的住院记录。对病历和影像进行人工审核以确定诊断。估算了CVST各种病例定义的PPV。
在380次住院病例中,分别确定166次和214次为急性CVST的真阳性和假阳性发作。ICD - 10 - CM编码G08、I629、I636和I676的PPV分别为88.2%、2.0%、100.0%和91.3%。当将急性CVST定义为主要诊断或定义为ICD - 10 - CM编码加抗凝剂使用时,PPV通常会增加。其他病症的编码错误、初步诊断以及CVST的远期发作被确定为急性CVST假阳性诊断的主要原因。
本研究确定了用于识别CVST的ICD - 10 - CM编码的PPV, 这可能为未来基于理赔的研究提供参考。