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Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources
PURPOSE: Validating cases of acute liver injury (ALI) in health care data sources is challenging. Previous validation studies reported low positive predictive values (PPVs). METHODS: Case validation was undertaken in a study conducted from 2009 to 2014 assessing the risk of ALI in antidepressants us...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6618105/ https://www.ncbi.nlm.nih.gov/pubmed/31172633 http://dx.doi.org/10.1002/pds.4803 |
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author | Forns, Joan Cainzos‐Achirica, Miguel Hellfritzsch, Maja Morros, Rosa Poblador‐Plou, Beatriz Hallas, Jesper Giner‐Soriano, Maria Prados‐Torres, Alexandra Pottegård, Anton Cortés, Jordi Castellsagué, Jordi Jacquot, Emmanuelle Deltour, Nicolas Perez‐Gutthann, Susana Pladevall, Manel |
author_facet | Forns, Joan Cainzos‐Achirica, Miguel Hellfritzsch, Maja Morros, Rosa Poblador‐Plou, Beatriz Hallas, Jesper Giner‐Soriano, Maria Prados‐Torres, Alexandra Pottegård, Anton Cortés, Jordi Castellsagué, Jordi Jacquot, Emmanuelle Deltour, Nicolas Perez‐Gutthann, Susana Pladevall, Manel |
author_sort | Forns, Joan |
collection | PubMed |
description | PURPOSE: Validating cases of acute liver injury (ALI) in health care data sources is challenging. Previous validation studies reported low positive predictive values (PPVs). METHODS: Case validation was undertaken in a study conducted from 2009 to 2014 assessing the risk of ALI in antidepressants users in databases in Spain (EpiChron and SIDIAP) and the Danish National Health Registers. Three ALI definitions were evaluated: primary (specific hospital discharge codes), secondary (specific and nonspecific hospital discharge codes), and tertiary (specific and nonspecific hospital and outpatient codes). The validation included review of patient profiles (EpiChron and SIDIAP) and of clinical data from medical records (EpiChron and Denmark). ALI cases were confirmed when liver enzyme values met a definition by an international working group. RESULTS: Overall PPVs (95% CIs) for the study ALI definitions were, for the primary ALI definition, 84% (60%‐97%) (EpiChron), 60% (26%‐88%) (SIDIAP), and 74% (60%‐85%) (Denmark); for the secondary ALI definition, 65% (45%‐81%) (EpiChron), 40% (19%‐64%) (SIDIAP), and 70% (64%‐77%) (Denmark); and for the tertiary ALI definition, 25% (18%‐34%) (EpiChron), 8% (7%‐9%) (SIDIAP), and 47% (42%‐52%) (Denmark). The overall PPVs were higher for specific than for nonspecific codes and for hospital discharge than for outpatient codes. The nonspecific code “unspecified jaundice” had high PPVs in Denmark. CONCLUSIONS: PPVs obtained apply to patients using antidepressants without preexisting liver disease or ALI risk factors. To maximize validity, studies on ALI should prioritize hospital specific discharge codes and should include hospital codes for unspecified jaundice. Case validation is required when ALI outpatient cases are considered. |
format | Online Article Text |
id | pubmed-6618105 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-66181052019-07-22 Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources Forns, Joan Cainzos‐Achirica, Miguel Hellfritzsch, Maja Morros, Rosa Poblador‐Plou, Beatriz Hallas, Jesper Giner‐Soriano, Maria Prados‐Torres, Alexandra Pottegård, Anton Cortés, Jordi Castellsagué, Jordi Jacquot, Emmanuelle Deltour, Nicolas Perez‐Gutthann, Susana Pladevall, Manel Pharmacoepidemiol Drug Saf Original Reports PURPOSE: Validating cases of acute liver injury (ALI) in health care data sources is challenging. Previous validation studies reported low positive predictive values (PPVs). METHODS: Case validation was undertaken in a study conducted from 2009 to 2014 assessing the risk of ALI in antidepressants users in databases in Spain (EpiChron and SIDIAP) and the Danish National Health Registers. Three ALI definitions were evaluated: primary (specific hospital discharge codes), secondary (specific and nonspecific hospital discharge codes), and tertiary (specific and nonspecific hospital and outpatient codes). The validation included review of patient profiles (EpiChron and SIDIAP) and of clinical data from medical records (EpiChron and Denmark). ALI cases were confirmed when liver enzyme values met a definition by an international working group. RESULTS: Overall PPVs (95% CIs) for the study ALI definitions were, for the primary ALI definition, 84% (60%‐97%) (EpiChron), 60% (26%‐88%) (SIDIAP), and 74% (60%‐85%) (Denmark); for the secondary ALI definition, 65% (45%‐81%) (EpiChron), 40% (19%‐64%) (SIDIAP), and 70% (64%‐77%) (Denmark); and for the tertiary ALI definition, 25% (18%‐34%) (EpiChron), 8% (7%‐9%) (SIDIAP), and 47% (42%‐52%) (Denmark). The overall PPVs were higher for specific than for nonspecific codes and for hospital discharge than for outpatient codes. The nonspecific code “unspecified jaundice” had high PPVs in Denmark. CONCLUSIONS: PPVs obtained apply to patients using antidepressants without preexisting liver disease or ALI risk factors. To maximize validity, studies on ALI should prioritize hospital specific discharge codes and should include hospital codes for unspecified jaundice. Case validation is required when ALI outpatient cases are considered. John Wiley and Sons Inc. 2019-06-06 2019-07 /pmc/articles/PMC6618105/ /pubmed/31172633 http://dx.doi.org/10.1002/pds.4803 Text en © 2019 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Reports Forns, Joan Cainzos‐Achirica, Miguel Hellfritzsch, Maja Morros, Rosa Poblador‐Plou, Beatriz Hallas, Jesper Giner‐Soriano, Maria Prados‐Torres, Alexandra Pottegård, Anton Cortés, Jordi Castellsagué, Jordi Jacquot, Emmanuelle Deltour, Nicolas Perez‐Gutthann, Susana Pladevall, Manel Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources |
title | Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources |
title_full | Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources |
title_fullStr | Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources |
title_full_unstemmed | Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources |
title_short | Validity of ICD‐9 and ICD‐10 codes used to identify acute liver injury: A study in three European data sources |
title_sort | validity of icd‐9 and icd‐10 codes used to identify acute liver injury: a study in three european data sources |
topic | Original Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6618105/ https://www.ncbi.nlm.nih.gov/pubmed/31172633 http://dx.doi.org/10.1002/pds.4803 |
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