Kwok Wang Chun, Tam Terence Chi Chun, Sing Chor Wing, Chan Esther Wai Yin, Cheung Ching-Lung
Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
J Asthma Allergy. 2023 Mar 27;16:315-321. doi: 10.2147/JAA.S405297. eCollection 2023.
Electronic health record (EHR) databases can facilitate epidemiology research into various diseases including asthma. Given the diagnostic challenges of asthma, the validity of the coding in EHR requires clarification. We aimed to assess the validity of International Classification of Diseases, 9th Revision (ICD-9) code algorithms for identifying asthma in the territory-wide electronic medical health record system of the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong.
Adult patients who had the diagnosis of asthma input from all public hospitals in Hong Kong and those from Queen Mary Hospital in 2011-2020 were identified using the ICD-9 code of 493 (493.0, 493.1, 493.2, and 493.9) by CDARS. Patients' clinical record and spirometry were reviewed by two respiratory specialists to confirm the presence of asthma in the randomly selected cases.
There were 43,454 patients who had the diagnostic code of asthma among all public hospitals in Hong Kong and 1852 in Queen Mary Hospital in the same period. A total of 200 cases were randomly selected and validated using medical record and spirometry review by a respiratory specialist. The overall positive predictive value (PPV) was 85.0% (95% CI 80.1-89.9%).
This was the first ICD-9 code validation for CDARS (EHR) in Hong Kong on asthma. Our study demonstrated that using ICD-9 code (493.0, 493.1, 493.2 and 493.9) to identify asthma can result in a PPV that was reliable to support the utility of the CDARS database for further research on asthma among the Hong Kong population.
电子健康记录（EHR）数据库有助于对包括哮喘在内的各种疾病进行流行病学研究。鉴于哮喘的诊断存在挑战，EHR中编码的有效性需要明确。我们旨在评估国际疾病分类第九版（ICD-9）编码算法在香港临床数据分析与报告系统（CDARS）的全港电子医疗健康记录系统中识别哮喘的有效性。
通过CDARS使用ICD-9编码493（493.0、493.1、493.2和493.9）识别2011年至2020年期间香港所有公立医院以及玛丽医院输入了哮喘诊断的成年患者。两名呼吸科专家对随机选择病例的患者临床记录和肺功能进行了审查，以确认哮喘的存在。
同期香港所有公立医院中有43454名患者有哮喘诊断编码，玛丽医院有1852名。总共随机选择了200例病例，并由呼吸科专家通过病历和肺功能检查进行验证。总体阳性预测值（PPV）为85.0%（95%CI 80.1-89.9%）。
这是香港首次对CDARS（EHR）关于哮喘的ICD-9编码进行验证。我们的研究表明，使用ICD-9编码（493.0、493.1、493.2和493.9）识别哮喘可得出可靠的PPV，以支持CDARS数据库用于香港人群哮喘进一步研究的效用。
