Digestive Disease Research Center, Medical University of South Carolina, Charleston, SC, USA.
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Dig Dis Sci. 2023 Jun;68(6):2360-2369. doi: 10.1007/s10620-023-07876-7. Epub 2023 Mar 10.
Cirrhosis represents a significant health burden; administrative data provide an important tool for research studies.
We aimed to understand the validity of current ICD-10 codes compared to previously used ICD-9 codes to identify patients with cirrhosis and its complications.
We identified 1981 patients presenting to MUSC between 2013 and 2019 with a diagnosis of cirrhosis. To validate the sensitivity of ICD codes, we reviewed the medical records of 200 patients for each associated ICD 9 and 10 codes. Sensitivity, specificity, and positive predictive value for each ICD code (individually or when combined) were calculated and univariate binary logistic models, for cirrhosis and its complications, predicted probabilities were used to calculate C-statistics.
Single ICD 9 and 10 codes were similarly insensitive for detection of cirrhosis, with sensitivity ranging from 5 to 94%. However, ICD-9 code combinations (when used as either/or) had high sensitivity and specificity for the detection of cirrhosis, with the combination of either 571.5 (or 456.21) or 571.2 codes having a C-statistic of 0.975. Combinations of ICD-10 codes were only slightly less sensitive and specific than ICD-9 codes for detection of cirrhosis (K76.6, or K70.31, plus K74.60 or K74.69, and K70.30 had a C-statistic of 0.927).
ICD-9 and ICD-10 codes when used alone were inaccurate for identifying cirrhosis. ICD-10 and ICD-9 codes had similar performance characteristics. Combinations of ICD codes exhibited the greatest sensitivity and specificity for detection of cirrhosis, and thus should be used to accurately identify cirrhosis.
肝硬化是一个重大的健康负担；行政数据为研究提供了重要工具。
我们旨在了解当前 ICD-10 代码与之前使用的 ICD-9 代码相比识别肝硬化及其并发症患者的准确性。
我们确定了 1981 名 2013 年至 2019 年期间在 MUSC 就诊的肝硬化患者。为了验证 ICD 编码的敏感性，我们对 200 名患者的每一个相关 ICD 9 和 10 编码的病历进行了回顾。计算了每个 ICD 编码（单独或组合时）的敏感性、特异性和阳性预测值，并使用单变量二项逻辑模型预测肝硬化及其并发症的概率，以计算 C 统计量。
单个 ICD 9 和 10 代码对肝硬化的检测都不敏感，敏感性范围为 5 至 94%。然而，ICD-9 代码组合（作为或/或）对肝硬化的检测具有高敏感性和特异性，组合使用 571.5（或 456.21）或 571.2 代码的 C 统计量为 0.975。ICD-10 代码组合在检测肝硬化方面的敏感性和特异性略低于 ICD-9 代码（K76.6 或 K70.31 加 K74.60 或 K74.69 和 K70.30 的 C 统计量为 0.927）。
ICD-9 和 ICD-10 代码单独使用时无法准确识别肝硬化。ICD-10 和 ICD-9 代码具有相似的性能特征。ICD 代码组合在检测肝硬化方面具有最大的敏感性和特异性，因此应用于准确识别肝硬化。
