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Evaluation of ICD-10 algorithms to identify hypopituitary patients in the Danish National Patient Registry

Authors: Agnethe Berglund; Morten Olsen; Marianne Andersen; Eigil Husted Nielsen; Ulla Feldt-Rasmussen; Caroline Kistorp; Claus Højbjerg Gravholt; +1 Authors

Evaluation of ICD-10 algorithms to identify hypopituitary patients in the Danish National Patient Registry

Abstract

Routinely collected health data may be valuable sources for conducting research. This study aimed to evaluate the validity of algorithms detecting hypopituitary patients in the Danish National Patient Registry (DNPR) using medical records as reference standard.Patients with International Classification of Diseases (10th edition [ICD-10]) diagnoses of hypopituitarism, or other diagnoses of pituitary disorders assumed to be associated with an increased risk of hypopituitarism, recorded in the DNPR during 2000-2012 were identified. Medical records were reviewed to confirm or disprove hypopituitarism.Hypopituitarism was confirmed in 911 patients. In a candidate population of 1,661, this yielded an overall positive predictive value (PPV) of 54.8% (95% confidence interval [CI]: 52.4-57.3). Using algorithms searching for patients recorded at least one, three or five times with a diagnosis of hypopituitarism (E23.0x) and/or at least once with a diagnosis of postprocedural hypopituitarism (E89.3x), PPVs gradually increased from 73.3% (95% CI: 70.6-75.8) to 83.3% (95% CI: 80.7-85.7). Completeness for the same algorithms, however, decreased from 90.8% (95% CI: 88.7-92.6) to 82.9% (95% CI: 80.3-85.3) respectively. Including data of hormone replacement in the same algorithms PPVs increased from 73.2% (95% CI: 70.6-75.7) to 82.6% (95% CI: 80.1-84.9) and completeness decreased from 94.3% (95% CI: 92.6-95.7) to 89.7% (95% CI: 87.5-91.6) with increasing records of E23.0x.The DNPR is a valuable data source to identify hypopituitary patients using a search criteria of at least five records of E23.0x and/or at least one record of E89.3x. Completeness is increased when including hormone replacement data in the algorithm. The consequences of misclassification must, however, always be considered.

Country
Denmark
Keywords

ICD-10 algorithms, Infectious and parasitic diseases, RC109-216, Hypopituitarism, hypopituitarism, Journal Article, Clinical Epidemiology, Registry health data, registry health data, Original Research

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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!
2
Average
Average
Average
Green
gold