Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Hong Kong Med J. 2024 Oct;30(5):380-385. doi: 10.12809/hkmj2210657. Epub 2024 Aug 29.
Electronic health record databases can facilitate epidemiology research regarding diseases such as chronic obstructive pulmonary disease (COPD), a common medical condition worldwide. We aimed to assess the validity of International Classification of Diseases, 9th Revision (ICD-9) code algorithms for identifying COPD in Hong Kong's territory-wide electronic health record system, the Clinical Data Analysis and Reporting System (CDARS).
Adult patients diagnosed with COPD at all public hospitals in Hong Kong and specifically at Queen Mary Hospital from 2011 to 2020 were identified using the ICD-9 code 496 (Chronic airway obstruction, not elsewhere classified) within the CDARS. Two respiratory specialists reviewed clinical records and spirometry results to confirm the presence of COPD in a randomly selected group of cases.
During the study period, 93 971 and 2479 patients had the diagnostic code for COPD at all public hospitals in Hong Kong and specifically at Queen Mary Hospital, respectively. Two hundred cases were randomly selected from Queen Mary Hospital for validation using medical records and spirometry results. The overall positive predictive value was 81.5% (95% confidence interval=76.1%-86.9%). We also developed an algorithm to identify COPD cases in our cohort.
This study represents the first validation of ICD-9 coding for COPD in the CDARS. Our findings demonstrated that the ICD-9 code 496 is a reliable indicator for identifying COPD cases, supporting the use of the CDARS database for further clinical research concerning COPD.
电子健康记录数据库可以促进有关慢性阻塞性肺疾病（COPD）等疾病的流行病学研究，COPD 是一种全球常见的疾病。我们旨在评估香港全地域电子健康记录系统临床数据分析和报告系统（CDARS）中用于识别 COPD 的国际疾病分类第 9 版（ICD-9）代码算法的有效性。
通过 CDARS 中的 ICD-9 代码 496（未在其他地方分类的慢性气道阻塞），在香港所有公立医院（尤其是玛丽医院）诊断为 COPD 的成年患者。两位呼吸科专家审查了临床记录和肺量计结果，以确认随机选择的一组病例中存在 COPD。
在研究期间，香港所有公立医院（尤其是玛丽医院）的诊断代码分别为 93971 和 2479 例 COPD。从玛丽医院随机选择了 200 例进行病历和肺量计结果验证。总体阳性预测值为 81.5%（95%置信区间=76.1%-86.9%）。我们还开发了一种算法来识别我们队列中的 COPD 病例。
这项研究代表了对 CDARS 中 COPD 的 ICD-9 编码的首次验证。我们的发现表明，ICD-9 代码 496 是识别 COPD 病例的可靠指标，支持使用 CDARS 数据库进行 COPD 相关的进一步临床研究。
