Positive predictive value and sensitivity of ICD-9-CM codes for identifying pediatric leukemia.
Pediatr Blood Cancer
; 69(2): e29383, 2022 02.
Article
em En
| MEDLINE
| ID: mdl-34773439
ABSTRACT
BACKGROUND:
To facilitate community-based epidemiologic studies of pediatric leukemia, we validated use of ICD-9-CM diagnosis codes to identify pediatric leukemia cases in electronic medical records of six U.S. integrated health plans from 1996-2015 and evaluated the additional contributions of procedure codes for diagnosis/treatment. PROCEDURES Subjects (N = 408) were children and adolescents born in the health systems and enrolled for at least 120 days after the date of the first leukemia ICD-9-CM code or tumor registry diagnosis. The gold standard was the health system tumor registry and/or medical record review. We calculated positive predictive value (PPV) and sensitivity by number of ICD-9-CM codes received in the 120-day period following and including the first code. We evaluated whether adding chemotherapy and/or bone marrow biopsy/aspiration procedure codes improved PPV and/or sensitivity.RESULTS:
Requiring receipt of one or more codes resulted in 99% sensitivity (95% confidence interval [CI] 98-100%) but poor PPV (70%; 95% CI 66-75%). Receipt of two or more codes improved PPV to 90% (95% CI 86-93%) with 96% sensitivity (95% CI 93-98%). Requiring at least four codes maximized PPV (95%; 95% CI 92-98%) without sacrificing sensitivity (93%; 95% CI 89-95%). Across health plans, PPV for four codes ranged from 84-100% and sensitivity ranged from 83-95%. Including at least one code for a bone marrow procedure or chemotherapy treatment had minimal impact on PPV or sensitivity.CONCLUSIONS:
The use of diagnosis codes from the electronic health record has high PPV and sensitivity for identifying leukemia in children and adolescents if more than one code is required.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Leucemia
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Classificação Internacional de Doenças
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article