Katie P. Osterhage, Yih-Ing Hser, Larissa J. Mooney, Seth Sherman, Andrew J. Saxon, Maja Ledgerwood, Caleb C. Holtzer, Margaret A. Gehring, Sarah E. Clingan, Megan E. Curtis, Laura-Mae Baldwin
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This study describes application of ICD-10 diagnosis codes for opioid use, dependence and abuse from an electronic health record (EHR) data extraction using data from the clinics' OUD patient registries and clinician/staff EHR entries.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Cross-sectional observational study.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Four rural primary care clinics in Washington and Idaho, USA.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>307 patients.</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>This study used three data sources from each clinic: (1) a limited dataset extracted from the EHR, (2) a clinic-based registry of patients with OUD and (3) the clinician/staff interface of the EHR (e.g. progress notes, problem list). Data source one included records with six commonly applied ICD-10 codes for opioid use, dependence and abuse: F11.10 (opioid abuse, uncomplicated), F11.20 (opioid dependence, uncomplicated), F11.21 (opioid dependence, in remission), F11.23 (opioid dependence with withdrawal), F11.90 (opioid use, unspecified, uncomplicated) and F11.99 (opioid use, unspecified with unspecified opioid-induced disorder). Care coordinators used data sources two and three to categorize each patient identified in data source one: (1) confirmed OUD diagnosis, (2) may have OUD but no confirmed OUD diagnosis, (3) chronic pain with no evidence of OUD and (4) no evidence for OUD or chronic pain.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>F11.10, F11.21 and F11.99 were applied most frequently to patients who had clinical diagnoses of OUD (64%, 89% and 79%, respectively). F11.20, F11.23 and F11.90 were applied to patients who had a diagnostic mix of OUD and chronic pain without OUD. The four clinics applied codes inconsistently.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Lack of uniform application of ICD diagnosis codes make it challenging to use diagnosis code data from EHR to identify a research population of persons with opioid use disorder.</p>\n </section>\n </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 1","pages":"160-168"},"PeriodicalIF":5.2000,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Identifying patients with opioid use disorder using International Classification of Diseases (ICD) codes: Challenges and opportunities\",\"authors\":\"Katie P. Osterhage, Yih-Ing Hser, Larissa J. Mooney, Seth Sherman, Andrew J. Saxon, Maja Ledgerwood, Caleb C. Holtzer, Margaret A. Gehring, Sarah E. Clingan, Megan E. 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Identifying patients with opioid use disorder using International Classification of Diseases (ICD) codes: Challenges and opportunities
Background and Aims
International Classification of Diseases (ICD) diagnosis codes are often used in research to identify patients with opioid use disorder (OUD), but their accuracy for this purpose is not fully evaluated. This study describes application of ICD-10 diagnosis codes for opioid use, dependence and abuse from an electronic health record (EHR) data extraction using data from the clinics' OUD patient registries and clinician/staff EHR entries.
Design
Cross-sectional observational study.
Setting
Four rural primary care clinics in Washington and Idaho, USA.
Participants
307 patients.
Measurements
This study used three data sources from each clinic: (1) a limited dataset extracted from the EHR, (2) a clinic-based registry of patients with OUD and (3) the clinician/staff interface of the EHR (e.g. progress notes, problem list). Data source one included records with six commonly applied ICD-10 codes for opioid use, dependence and abuse: F11.10 (opioid abuse, uncomplicated), F11.20 (opioid dependence, uncomplicated), F11.21 (opioid dependence, in remission), F11.23 (opioid dependence with withdrawal), F11.90 (opioid use, unspecified, uncomplicated) and F11.99 (opioid use, unspecified with unspecified opioid-induced disorder). Care coordinators used data sources two and three to categorize each patient identified in data source one: (1) confirmed OUD diagnosis, (2) may have OUD but no confirmed OUD diagnosis, (3) chronic pain with no evidence of OUD and (4) no evidence for OUD or chronic pain.
Findings
F11.10, F11.21 and F11.99 were applied most frequently to patients who had clinical diagnoses of OUD (64%, 89% and 79%, respectively). F11.20, F11.23 and F11.90 were applied to patients who had a diagnostic mix of OUD and chronic pain without OUD. The four clinics applied codes inconsistently.
Conclusions
Lack of uniform application of ICD diagnosis codes make it challenging to use diagnosis code data from EHR to identify a research population of persons with opioid use disorder.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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