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The use of ICD codes to identify IBD subtypes and phenotypes of the Montreal classification in the Swedish National Patient Register.
Shrestha, Sarita; Olén, Ola; Eriksson, Carl; Everhov, Åsa H; Myrelid, Pär; Visuri, Isabella; Ludvigsson, Jonas F; Schoultz, Ida; Montgomery, Scott; Sachs, Michael C; Halfvarson, Jonas; Olsson, Malin; Hjortswang, Henrik; Bengtsson, Jonas; Strid, Hans; Andersson, Marie; Jäghult, Susanna; Eberhardson, Michael; Nordenvall, Caroline; Björk, Jan; Fagerberg, Ulrika L; Rejler, Martin; Grip, Olof; Karling, Pontus; Block, Mattias; Angenete, Eva; Hellström, Per M; Gustavsson, Anders.
Afiliação
  • Shrestha S; School of Medical Sciences, Örebro University, Örebro, Sweden.
  • Olén O; Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
  • Eriksson C; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Everhov ÅH; Department of Pediatric Gastroenterology and Nutrition, Sachs' Children and Youth Hospital, Stockholm, Sweden.
  • Myrelid P; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Visuri I; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Ludvigsson JF; Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
  • Schoultz I; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Montgomery S; Division of Surgery, Department of Clinical and Experimental Medicine, Faulty of Health Sciences, Linköping University.
  • Sachs MC; Department of Surgery, County Council of Östergötland Linköping, Linköping, Sweden.
  • Halfvarson J; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Olsson M; Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden.
  • Hjortswang H; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
  • Bengtsson J; Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
  • Strid H; School of Medical Sciences, Örebro University, Örebro, Sweden.
  • Andersson M; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Jäghult S; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
  • Eberhardson M; Department of Epidemiology and Public Health, University College London, London, UK.
  • Nordenvall C; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Björk J; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Rejler M; Department of Surgery, County Council of Östergötland, Linköping, Sweden.
  • Grip O; Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
  • Karling P; Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
  • Block M; Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden.
  • Angenete E; Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden.
  • Hellström PM; Stockholm Gastro Center, Karolinska Institutet, Stockholm, Sweden.
  • Gustavsson A; Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Scand J Gastroenterol ; 55(4): 430-435, 2020 Apr.
Article em En | MEDLINE | ID: mdl-32370571
ABSTRACT

Introduction:

Whether data on International Classification of Diseases (ICD)-codes from the Swedish National Patient Register (NPR) correctly correspond to subtypes of inflammatory bowel disease (IBD) and phenotypes of the Montreal classification scheme among patients with prevalent disease is unknown.Materials and

methods:

We obtained information on IBD subtypes and phenotypes from the medical records of 1403 patients with known IBD who underwent biological treatment at ten Swedish hospitals and retrieved information on their IBD-associated diagnostic codes from the NPR. We used previously described algorithms to define IBD subtypes and phenotypes. Finally, we compared these register-generated subtypes and phenotypes with the corresponding information from the medical records and calculated positive predictive values (PPV) with 95% confidence intervals.

Results:

Among patients with clinically confirmed disease and diagnostic listings of IBD in the NPR (N = 1401), the PPV was 97 (96-99)% for Crohn's disease, 98 (97-100)% for ulcerative colitis, and 8 (4-11)% for IBD-unclassified. The overall accuracy for age at diagnosis was 95% (when defined as A1, A2, or A3). Examining the validity of codes representing disease phenotype, the PPV was 36 (32-40)% for colonic Crohn's disease (L2), 61 (56-65)% for non-stricturing/non-penetrating Crohn's disease behaviour (B1) and 83 (78-87)% for perianal disease. Correspondingly, the PPV was 80 (71-89)% for proctitis (E1)/left-sided colitis (E2) in ulcerative colitis.

Conclusions:

Among people with known IBD, the NPR is a reliable source of data to classify most subtypes of prevalent IBD, even though misclassification commonly occurred in Crohn's disease location and behaviour and also among IBD-unclassified patients.
Assuntos
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Inflamatórias Intestinais / Sistema de Registros / Valor Preditivo dos Testes Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País como assunto: Europa Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Inflamatórias Intestinais / Sistema de Registros / Valor Preditivo dos Testes Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País como assunto: Europa Idioma: En Ano de publicação: 2020 Tipo de documento: Article