<p>Validity of ICD-10 diagnoses of overweight and obesity in Danish hospitals</p>

Abstract

PurposeHealth care databases may be a valuable source for epidemiological research in obesity, if diagnoses are valid. We examined the validity and completeness of International Classification of Diseases, 10th revision [ICD-10] diagnosis coding for overweight/obesity in Danish hospitals.Patients and methodsWe linked data from the Danish National Patient Registry on patients with a hospital diagnosis code of overweight/obesity (ICD-10 code E66) with computerized height and weight measurements made during hospital contacts in the Central Denmark Region Clinical Information System. We computed the positive predictive value (PPV) of the IDC-10 diagnosis of overweight/obesity, using a documented body mass index (BMI) ≥25 kg/m2 as gold standard. We also examined the completeness of obesity/overweight diagnosis coding among all patients recorded with BMI ≥25 kg/m2.ResultsOf all 19,672 patients registered with a first diagnosis code of overweight/obesity in the National Patient Registry, 17,351 patients (88.2%) had any BMI measurement recorded in the Central Denmark Region Clinical Information System, and 17,240 patients (87.6%) had a BMI ≥25 kg/m2, yielding a PPV of 87.6% (95% CI: 87.2–88.1). The PPV was slightly higher for primary diagnosis codes of overweight/obesity: 94.1% (95% CI: 93.3–94.8) than for secondary diagnosis codes: 86.1% (95% CI: 85.6–86.6). The PPV increased with higher patient age: from 75.3% (95% CI: 73.8–76.9) in those aged 18–29 years to 94.7% (95% CI: 92.6–96.9) in patients aged 80 years and above. Completeness of obesity/overweight diagnosis coding among patients recorded with BMI ≥25 kg/m2 was only 10.9% (95% CI: 10.8–11.0).ConclusionOur findings indicate a high validity of the ICD-10 code E66 for overweight/obesity when recorded; however, completeness of coding was low. Nonetheless, ICD-10 discharge codes may be a suitable source of data on overweight/obesity for epidemiological research.

Adverse outcomes and mortality in users of non-steroidal anti-inflammatory drugs who tested positive for SARS-CoV-2: A Danish nationwide cohort study

“…This is also a likely explanation for the relatively low prevalence of overweight or obesity in this study. The positive predictive value of these diagnoses in the registries is, however, high [28].…”

Hospital‐diagnosed overweight and obesity related to cancer risk: a 40‐year Danish cohort study

“…We had no information on the exact BMIs. Although we found that the overweight and obesity diagnosis code had high specificity, completeness of coding of overweight and obesity was low . Obesity is rarely a primary cause of hospital admission, and it may be an important contributing factor to many admissions.…”

“…Obesity is rarely a primary cause of hospital admission, and it may be an important contributing factor to many admissions. Completeness was higher among women than men, and was highest among patients aged 30–39 years, which must be taken into account when interpreting our results . We did not have access to individual patient records, thus we had no information on smoking, alcohol intake, and physical activity.…”

“…From the DNPR, we identified individuals assigned an inpatient or outpatient clinical diagnosis code of overweight or obesity, recorded at any Danish hospital, during 1977–2016 (Tables and for codes and frequencies of use of codes) . The positive predictive value of overweight and obesity diagnosis codes in Danish hospitals was 87.6% [95% confidence interval (CI): 87.2–88.1] . Completeness of coding was, however, low: estimated completeness of overweight and obesity diagnosis coding among patients recorded with BMI ≥25 kg m −2 was 10.9% (95% CI: 10.8–11.0).…”

Findings from the Health Information Management Section of the 2020 International Medical Informatics Association Yearbook

“…The researchers found discrepancies at all levels and variability among the different variables, with some showing high accuracy and others showing low quality. Gribsholt et al, [6] also looked at multiple information sources to validate the diagnoses of overweight and obesity in Denmark. The researchers compared diagnoses of overweight and obesity with BMI data.…”