Identifying Patients With Primary Biliary Cholangitis and Cirrhosis Using Administrative Data in a National Cohort.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-10-01 DOI:10.1002/pds.70013

Binu V John, Dustin Bastaich, Bassam Dahman

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Abstract

Background: The accuracy of administrative codes to capture patients with both primary biliary cholangitis (PBC) and cirrhosis could be challenging because of the potential for incorrect coding due to the old nomenclature "Primary Biliary Cirrhosis." Therefore, the aim of this study was to examine the positive predictive value (PPV) of International Classification of Diseases (ICD) codes for PBC and cirrhosis.

Methods: This was a retrospective cohort study using data from the VA Corporate Data Warehouse. Eligibility criteria included adult patients diagnosed to have PBC and cirrhosis based on one inpatient or two outpatient ICD 9 or 10 codes, and were validated against chart review of each participant.

Results: We identified 1408 patients who were found to have ICD codes for both cirrhosis and PBC. The ICD 9/10 codes for PBC and cirrhosis had a PPV of 0.75 (95% CI 0.73-0.75) for cirrhosis, 0.75 for PBC (95% CI 0.73-0.78), and 0.52 (0.50-0.55) for PBC and cirrhosis. When portal hypertension was combined with ICD 9/10 codes, the PPV of cirrhosis improved to 0.92 (0.90-0.94), and that of PBC cirrhosis improved to 0.64 (0.60-0.67). By combining ICD 9/10 codes for portal hypertension and receipt of ursodeoxycholic acid (UDCA), the PPV for cirrhosis improved to 0.91 (0.88-0.94), PBC increased to 0.78 (0.74-0.82), and that for PBC cirrhosis to 0.69 (0.65-0.74).

Conclusions: In a large national cohort, the use of ICD 9/10 codes had modest reliability for identifying participants with PBC and cirrhosis. The PPV for cirrhosis can be improved by incorporating ICD 9/10 codes for portal hypertension with receipt of UDCA.

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利用全国队列中的管理数据识别原发性胆汁性胆管炎和肝硬化患者。

背景：由于旧术语 "原发性胆汁性肝硬化 "可能会导致编码错误，因此准确捕捉原发性胆汁性胆管炎（PBC）和肝硬化患者的管理编码具有挑战性。因此，本研究旨在检验国际疾病分类 (ICD) 代码对 PBC 和肝硬化的阳性预测值 (PPV)：这是一项回顾性队列研究，使用的数据来自退伍军人事务部企业数据仓库。资格标准包括根据一个住院病人或两个门诊病人的 ICD 9 或 10 编码诊断为 PBC 和肝硬化的成年病人，并根据每位参与者的病历审查进行验证：结果：我们发现有 1408 名患者的 ICD 编码同时包含肝硬化和 PBC。PBC 和肝硬化的 ICD 9/10 编码对肝硬化的 PPV 值为 0.75（95% CI 0.73-0.75），对 PBC 的 PPV 值为 0.75（95% CI 0.73-0.78），对 PBC 和肝硬化的 PPV 值为 0.52（0.50-0.55）。当门脉高压与 ICD 9/10 编码相结合时，肝硬化的 PPV 提高到 0.92（0.90-0.94），PBC 肝硬化的 PPV 提高到 0.64（0.60-0.67）。通过合并门脉高压和接受熊去氧胆酸（UDCA）的 ICD 9/10 编码，肝硬化的 PPV 提高到 0.91（0.88-0.94），PBC 提高到 0.78（0.74-0.82），PBC 肝硬化的 PPV 提高到 0.69（0.65-0.74）：结论：在一个大型全国队列中，使用 ICD 9/10 编码识别 PBC 和肝硬化患者的可靠性不高。通过将门静脉高压的 ICD 9/10 编码与接受 UDCA 的情况相结合，可以提高肝硬化的 PPV。

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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.