Standardization of coding definitions for sickle cell disease complications: A systematic literature review.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-09-01 DOI:10.1002/pds.5769

Paulette Negron Ericksen, Firas Dabbous, Rajrupa Ghosh, Surbhi Shah, Xunming Sun, Emily Riehm Meier, Carmine Colavecchia

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Abstract

Purpose: Sickle cell disease (SCD) affects all organ systems and is characterized by numerous acute and chronic complications and comorbidities. Standardized codes are needed for complications/comorbidities used in real-world evidence (RWE) studies that rely on administrative and medical coding. This systematic literature review was conducted to produce a comprehensive list of complications/comorbidities associated with SCD, along with their diagnosis codes used in RWE studies.

Methods: A search in MEDLINE and Embase identified studies published from 2016 to 2023. Studies were included if they were conducted in US SCD populations and reported complications/comorbidities and respective International Classification of Diseases, Clinical Modification (ICD-CM) codes. All identified complications/comorbidities and codes were reviewed by a certified medical coding expert and hematologist.

Results: Of 1851 identified studies, 39 studies were included. The most reported complications/comorbidities were stroke, acute chest syndrome, pulmonary embolism, venous thromboembolism, and vaso-occlusive crisis. Most of the studies used ICD-9-CM codes (n = 21), while some studies used ICD-10-CM codes (n = 3) or both (n = 15), depending on the study period. Most codes reported in literature were heterogeneous across complications/comorbidities. The medical coding expert and hematologist recommended modifications for several conditions.

Conclusion: While many studies we identified did not report their codes and were excluded from this review, the studies with codes exhibited diverse coding definitions. By providing a standardized set of diagnosis codes that were reported by studies and reviewed by a coding expert and hematologist, our review can serve as a foundation for accurately identifying complications/comorbidities in future research, and may reduce heterogeneity, enhance transparency, and improve reproducibility. Future efforts focused on validating these code lists are needed.

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镰状细胞病并发症编码定义的标准化：系统文献综述。

目的：镰状细胞病（SCD）影响所有器官系统，并伴有许多急性和慢性并发症及合并症。真实世界证据（RWE）研究中使用的并发症/合并症需要标准化的代码，这些代码依赖于行政和医疗编码。本系统性文献综述旨在编制一份与 SCD 相关的并发症/合并症及其在 RWE 研究中使用的诊断代码的综合清单：方法：在 MEDLINE 和 Embase 中检索了 2016 年至 2023 年间发表的研究。如果研究是在美国SCD人群中进行的，并报告了并发症/合并症和相应的国际疾病分类、临床修正（ICD-CM）代码，则纳入这些研究。所有已确定的并发症/合并症和代码均由认证医疗编码专家和血液病专家进行了审查：结果：在 1851 项已确定的研究中，有 39 项研究被纳入。报告最多的并发症/合并症是中风、急性胸部综合征、肺栓塞、静脉血栓栓塞和血管闭塞性危象。大多数研究使用了 ICD-9-CM 编码（21 例），而一些研究使用了 ICD-10-CM 编码（3 例）或两者（15 例），具体取决于研究时间。文献中报告的大多数代码在并发症/合并症方面存在差异。医学编码专家和血液病专家建议对几种情况进行修改：尽管我们发现的许多研究没有报告其编码，因此被排除在本综述之外，但有编码的研究显示了不同的编码定义。我们的综述提供了一套由研究报告并由编码专家和血液病专家审核的标准化诊断代码，可作为未来研究中准确识别并发症/合并症的基础，并可减少异质性、提高透明度和可重复性。今后还需努力验证这些代码表。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.