一种在退伍军人健康管理局电子健康记录系统中识别肝性失代偿的验证算法。
A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System.
机构信息
Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA.
出版信息
Pharmacoepidemiol Drug Saf. 2024 Nov;33(11):e70024. doi: 10.1002/pds.70024.
PURPOSE
Accurate identification of hepatic decompensation is essential for pharmacoepidemiologic research among patients with chronic liver disease.
METHODS
An algorithm using ≥ 1 inpatient or ≥ 2 outpatient International Classification of Diseases, 10th revision (ICD-10) codes for hepatic decompensation was developed in Veterans Health Administration data from October 2015 through July 2019. Medical records were reviewed by hepatologists to confirm cases. The positive predictive value (PPV) of the coding algorithm for confirmed hepatic decompensation was calculated.
RESULTS
Hepatic decompensation was confirmed in 149/185 records meeting the algorithm (PPV 81%; 95% CI, 70%, 90%). The most common hepatic decompensation diagnosis was ascites. Only 56% of confirmed cases had an accompanying diagnosis code for cirrhosis.
CONCLUSIONS
Our ICD-10-based coding algorithm identified hepatic decompensation with high PPV in Veterans Health Administration data.
目的
准确识别肝失代偿对于慢性肝病患者的药物流行病学研究至关重要。
方法
在退伍军人健康管理局（Veterans Health Administration） 2015 年 10 月至 2019 年 7 月的数据中，开发了一种使用国际疾病分类第 10 版（ICD-10）≥1 次住院或≥2 次门诊肝失代偿编码的算法。由肝病专家对病历进行审查以确认病例。计算编码算法对确诊肝失代偿的阳性预测值（PPV）。
结果
符合算法的 185 份记录中有 149 份（PPV81%；95%CI，70%，90%）确认存在肝失代偿。最常见的肝失代偿诊断为腹水。仅有 56%的确诊病例伴有肝硬化的诊断代码。
结论
我们的基于 ICD-10 的编码算法在退伍军人健康管理局数据中识别肝失代偿具有较高的 PPV。
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