descriptionPublicationkeyboard_double_arrow_right Article , Other literature type 06 Jun 2019 English Publisher:WileyJournal:Pharmacoepidemiology and Drug Safety, volume 28, pages 965-975 (issn: 1053-8569, eissn: 1099-1557,

Authors: Joan Forns; Miguel Cainzos‐Achirica; Maja Hellfritzsch; Rosa Morros; Beatriz Poblador‐Plou; Jesper Hallas; Maria Giner‐Soriano; +8 Authors

doi: 10.1002/pds.4803

pmid: 31172633

pmc: PMC6618105

handle: 123456789/4127 , 11351/4127 , 2117/174747 , 2072/446802

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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Abstract

AbstractPurposeValidating cases of acute liver injury (ALI) in health care data sources is challenging. Previous validation studies reported low positive predictive values (PPVs).MethodsCase 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.ResultsOverall 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.ConclusionsPPVs 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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Keywords

Àrees temàtiques de la UPC::Matemàtiques i estadística::Estadística aplicada::Estadística biosanitària, Male, pharmacoepidemiology, Databases, Factual, Denmark, :Digestive System Diseases::Liver Diseases::Hepatic Insufficiency::Liver Failure::Liver Failure, Acute [DISEASES], acute liver injury, :acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos del sistema nervioso central::fármacos psicotrópicos::antidepresivos [COMPUESTOS QUÍMICOS Y DROGAS], sample surveys, :Health Occupations::Medicine::Public Health::Epidemiology::Health Occupations::Pharmacoepidemiology [DISCIPLINES AND OCCUPATIONS], :profesiones sanitarias::medicina::salud pública::epidemiología::profesiones sanitarias::farmacoepidemiología [DISCIPLINAS Y OCUPACIONES], Validation, COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos del sistema nervioso central::fármacos psicotrópicos::antidepresivos, Other subheadings::Other subheadings::Other subheadings::/utilization, validation, Aged, 80 and over, :92 Biology and other natural sciences::92B Mathematical biology in general [Classificació AMS], DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::salud pública::epidemiología::profesiones sanitarias::farmacoepidemiología, Antidepressius, Antidepressants, Middle Aged, Registres mèdics, ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::insuficiencia hepática::fracaso hepático::fracaso hepático agudo, antidepressants, :Other subheadings::Other subheadings::/utilization [Other subheadings], Female, Chemical and Drug Induced Liver Injury, Adult, Àrees temàtiques de la UPC::Matemàtiques i estadística::Estadística matemàtica::Anàlisi multivariant, Biomatemàtica, Classificació AMS::62 Statistics::62D05 Sampling theory, sample surveys, Adolescent, injury, :epidemiología y bioestadística::bioestadística::clasificaciones en salud::Clasificación Internacional de Enfermedades [SALUD PÚBLICA], DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Public Health::Epidemiology::Health Occupations::Pharmacoepidemiology, Classificació AMS::92 Biology and other natural sciences::92B Mathematical biology in general, :Epidemiology and Biostatistics::Biostatistics::Health Classifications::International Classification of Diseases [PUBLIC HEALTH], :62 Statistics::62D05 Sampling theory, sample surveys [Classificació AMS], Insuficiència hepàtica - Diagnòstic, pharmacoepidemiology validation, Young Adult, Classificació AMS::62 Statistics::62D05 Sampling theory, SALUD PÚBLICA::epidemiología y bioestadística::bioestadística::clasificaciones en salud::Clasificación Internacional de Enfermedades, DISEASES::Digestive System Diseases::Liver Diseases::Hepatic Insufficiency::Liver Failure::Liver Failure, Acute, Original Reports, Acute liver injury, :Matemàtiques i estadística::Estadística matemàtica::Anàlisi multivariant [Àrees temàtiques de la UPC], Humans, Sampling (Statistics), Diagnosis-Related Groups, Aged, Biomathematics, :Matemàtiques i estadística::Estadística aplicada::Estadística biosanitària [Àrees temàtiques de la UPC], :Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Psychotropic Drugs::Antidepressive Agents [CHEMICALS AND DRUGS], :enfermedades del sistema digestivo::enfermedades hepáticas::insuficiencia hepática::fracaso hepático::fracaso hepático agudo [ENFERMEDADES], CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Psychotropic Drugs::Antidepressive Agents, Pharmacoepidemiology, acute liver, :Otros calificadores::Otros calificadores::/utilización [Otros calificadores], Reproducibility of Results, Otros calificadores::Otros calificadores::Otros calificadores::/utilización, Spain, Mostreig (Estadística), PUBLIC HEALTH::Epidemiology and Biostatistics::Biostatistics::Health Classifications::International Classification of Diseases, Farmacoepidemiologia

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