ICD-10-CM 出生时胎龄诊断编码的验证。
Validation of ICD-10-CM Diagnosis Codes for Gestational Age at Birth.
机构信息
From the Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford School of Medicine, Stanford, CA.
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford School of Medicine, Stanford, CA.
出版信息
Epidemiology. 2023 Jan 1;34(1):64-68. doi: 10.1097/EDE.0000000000001557. Epub 2022 Sep 27.
BACKGROUND
The International Classification of Diseases , 10th Revision, Clinical Modification (ICD-10-CM) introduced diagnosis codes for week of gestation. Our objective was to assess the validity of these codes among live births, which could have major utility in perinatal research and quality improvement.
METHODS
We used linked birth certificate and patient discharge data from births in California during 2016-2019 (N = 1,843,992). We identified gestational age using Z3A.xx ICD-10-CM diagnosis codes in birthing patient discharge data and compared it with the gold standard of obstetric estimate, as recorded on the birth certificate. We further assessed sensitivity and specificity of gestational age categories (≥37 weeks, <37 weeks, <32 weeks, <28 weeks), given these categories are frequently of interest, and evaluated differences in validity of preterm birth (<37 weeks' gestation) by patient characteristics.
RESULTS
One-million seven-hundred seventy-thousand one-hundred three patients had a gestational age recorded in patient discharge and birth certificate data. When comparing gestational age in patient discharge data with birth certificate data, the concordance correlation coefficient was 0.96 (95% confidence interval [CI] = 0.96, 0.96) and the mean difference between the two measurements was 0.047 weeks (95% CI = 0.046, 0.047 weeks). Ninety-five percent of the differences between the two measurements were between -1.00 week and +1.09 weeks. Sensitivity and specificity were 0.94 to 1.00 for all gestational age categories and were 0.94 to 1.00 for preterm birth across sociodemographic groups.
CONCLUSIONS
We found week-specific gestational age at delivery ICD-10-CM diagnosis codes in patient discharge data to have high validity when compared with the best obstetric estimate on the birth certificate.
背景
国际疾病分类第十版临床修订版（ICD-10-CM）引入了孕周诊断代码。我们的目的是评估这些代码在活产儿中的有效性，这在围产期研究和质量改进中可能具有重要作用。
方法
我们使用了加利福尼亚州 2016-2019 年出生的出生证明和患者出院数据进行链接（N=1843992）。我们使用 Z3A.xx ICD-10-CM 诊断代码在分娩患者的出院数据中确定胎龄，并将其与出生证明上记录的产科估计值的金标准进行比较。我们进一步评估了胎龄类别（≥37 周、<37 周、<32 周、<28 周）的敏感性和特异性，因为这些类别通常是研究的重点，并评估了患者特征对早产（<37 周妊娠）有效性的差异。
结果
有 177 万 1103 名患者在患者出院和出生证明数据中记录了胎龄。当比较患者出院数据中的胎龄与出生证明数据时，一致性相关系数为 0.96（95%置信区间[CI] = 0.96，0.96），两种测量方法之间的平均差异为 0.047 周（95%CI = 0.046，0.047 周）。两种测量方法之间 95%的差异在-1.00 周和+1.09 周之间。所有胎龄类别的敏感性和特异性均为 0.94 至 1.00，社会人口统计学组别的早产敏感性和特异性均为 0.94 至 1.00。
结论
与出生证明上的最佳产科估计值相比，我们发现患者出院数据中特定孕周的分娩 ICD-10-CM 诊断代码具有很高的有效性。
Zotero 插件