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Title:
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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
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Author:
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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-Vila, Manel
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Other authors:
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Institut Català de la Salut; [Forns J, Cainzos-Achirica M, Castellsagué J, Perez-Gutthann S] Epidemiology, RTI Health Solutions, Barcelona, Spain. [Hellfritzsch M, Hallas J, Pottegård A] Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark. [Morros R, Giner-Soriano M] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain. Institut Català de la Salut, Barcelona, Spain. [Poblador-Plou B, Prados-Torres A] EpiChron, Instituto Aragonés de Ciencias de la Salud, (IACS), IIS Aragón, REDISSEC ISCIII, Zaragoza, Spain. [Cortés J] Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya, Barcelona, Spain. [Jacquot E, Deltour N] Pharmacoepidemiology Department, Les Laboratoires Servier, Paris, France. [Pladevall M] Epidemiology, RTI Health Solutions, Barcelona, Spain. The Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA.; IDIAP Jordi Gol |
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Abstract:
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Acute liver injury; Antidepressants; Pharmacoepidemiology |
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Abstract:
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Lesió hepàtica aguda; Antidepressius; Farmacoepidemiologia |
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Abstract:
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Lesión hepática aguda; Antidepresivos; Farmacoepidemiología |
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Abstract:
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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. |
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Subject(s):
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-Farmacoepidemiologia
-Antidepressius
-Registres mèdics
-Insuficiència hepàtica - Diagnòstic
-PUBLIC HEALTH::Epidemiology and Biostatistics::Biostatistics::Health Classifications::International Classification of Diseases
-Other subheadings::Other subheadings::Other subheadings::/utilization
-DISEASES::Digestive System Diseases::Liver Diseases::Hepatic Insufficiency::Liver Failure::Liver Failure, Acute
-CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Psychotropic Drugs::Antidepressive Agents
-DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Public Health::Epidemiology::Health Occupations::Pharmacoepidemiology
-SALUD PÚBLICA::epidemiología y bioestadística::bioestadística::clasificaciones en salud::Clasificación Internacional de Enfermedades
-Otros calificadores::Otros calificadores::Otros calificadores::/utilización
-ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::insuficiencia hepática::fracaso hepático::fracaso hepático agudo
-COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos del sistema nervioso central::fármacos psicotrópicos::antidepresivos
-DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::salud pública::epidemiología::profesiones sanitarias::farmacoepidemiología |
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Rights:
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Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Document type:
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Article
Article - Published version |
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Published by:
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Wiley Online Library
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