Sensitivity of health records for self-reported nonfatal drug and alcohol overdose.
Am J Addict
; 31(6): 517-522, 2022 11.
Article
en En
| MEDLINE
| ID: mdl-36000282
ABSTRACT
BACKGROUND AND OBJECTIVES:
Public health surveillance for overdose sometimes depends on nonfatal drug overdoses recorded in health records. However, the proportion of total overdoses identified through health record systems is unclear. Comparison of overdoses from health records to those that are self-reported may provide insight on the proportion of nonfatal overdoses that are not identified.METHODS:
We conducted a cohort study linking survey data on overdose from a national survey of Veterans to United States Department of Veterans Affairs (VA) health records, including community care paid for by VA. Self-reported overdose in the prior 3 years was compared to diagnostic codes for overdoses and substance use disorders in the same time period.RESULTS:
The sensitivity of diagnostic codes for overdose, compared to self-report as a reference standard for this analysis, varied by substance 28.1% for alcohol, 23.1% for sedatives, 12.0% for opioids, and 5.5% for cocaine. There was a notable concordance between substance use disorder diagnoses and self-reported overdose (sensitivity range 17.9%-90.6%). DISCUSSION ANDCONCLUSIONS:
Diagnostic codes in health records may not identify a substantial proportion of drug overdoses. A health record diagnosis of substance use disorder may offer a stronger inference regarding the size of the population at risk. Alternatively, screening for self-reported overdose in routine clinical care could enhance overdose surveillance and targeted intervention. SCIENTIFICSIGNIFICANCE:
This study suggests that diagnostic codes for overdose are insensitive. These findings support consideration of alternative approaches to overdose surveillance in public health.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Trastornos Relacionados con Sustancias
/
Sobredosis de Droga
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2022
Tipo del documento:
Article