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Annals of Epidemiology
Article . 2025 . Peer-reviewed
License: CC BY
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Validation of ICD-10 diagnostic coding for influenza in the Danish National Patient Registry

Authors: Bo Langhoff Hønge; Kristoffer Skaalum Hansen; Marianne Kragh Thomsen; Lars Østergaard; Trine Hyrup Mogensen; Merete Storgaard; Christian Erikstrup; +1 Authors

Validation of ICD-10 diagnostic coding for influenza in the Danish National Patient Registry

Abstract

The accuracy of recorded diagnosis codes for hospital admissions due to influenza in the Danish national registries is uncertain. We evaluated positive predictive value (PPV) and sensitivity of ICD-10 codes for influenza by comparing to the reference standard of influenza test results.Hospital admissions were assessed in the Danish National Patient Registry (DNPR), and influenza test results in the Danish Microbiology Database (MiBa). First, we report the proportion of positive influenza virus tests within seven days of admission among hospital admissions with a discharge influenza ICD-10 code (PPV). Second, we report the proportion with ICD-10 codes for influenza among patients with an admission registered with seven days of a positive influenza virus test (sensitivity).From January 2012 - November 2022 a total of 18,761 admissions were registered with one of the 22 influenza ICD-10 codes in DNPR. Overall, there was a positive influenza test in 16,754 of the admissions (87.9 % = overall PPV, 95 % CI: 87.4-88.3). The PPV was highest for older patient groups (93.7 % in patients >80 years vs. 78.0 % in patients < 11 years), and for admissions that occurred in recent years (95.8 % in 2022 vs. 52.4 % in 2012). Among 33,834 hospitals admissions with a positive influenza test, less than half (n = 16,421, 48.5 % = sensitivity (95 % CI: 48.0 - 49.1 %)) were registered with an influenza ICD-10 code.ICD-10 diagnoses codes have relatively high positive predictive value, but the sensitivity is low. Furthermore, the PPV depend on age and calendar year.

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Keywords

Male, Adult, Aged, 80 and over, Positive predictive value, Adolescent, Epidemiology, Denmark, Clinical Coding, Infant, Middle Aged, Sensitivity and Specificity, Hospitalization, Young Adult, Sensitivity, International Classification of Diseases, Predictive Value of Tests, Child, Preschool, Influenza, Human, Humans, Female, International Classification of Disease codes, Registries, Child, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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