Validating opioid use disorder diagnoses in administrative data: a commentary on existing evidence and future directions

BACKGROUND: A valid opioid use disorder (OUD) identification algorithm for use in administrative medical record data would enhance investigators’ ability to study consequences of OUD, OUD treatment seeking and treatment outcomes. MAIN BODY: Existing studies indicate ICD-9 and ICD-10 codes for opioid abuse and dependence do not accurately measure OUD. However, critical appraisal of existing literature suggests alternative validation methods would improve the validity of OUD identification algorithms in administrative data. Chart abstraction may not be sufficient to validate OUD, and primary data collection via structured diagnostic interviews might be an ideal gold standard. CONCLUSION AND COMMENTARY: Generating valid OUD identification algorithms is critical for OUD research and quality measurement in real world health care settings.