Use of Billing and Procedure Codes to Predict Stage of Liver Disease in Patients with Chronic Viral Hepatitis

Rabin, David L.; Chacra, Wadih; Gordon, Stuart C.; Yang, James; Rupp, Loralee B

doi:10.14309/00000434-201310001-00496

Cited by 1 publication

(16 citation statements)

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“…The sample size ranged between 84 and 6714 people, with a total of 18 704 patients included. Twelve studies were conducted in the United States, [9][10][11][12][13][14][15][16][17][18][19][20] two in Denmark, 21,22 two in Canada 23,24 and two in the United Kingdom. 25,26 Of those studies from the United States, five used cohorts from the Veterans Administration (VA) population.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…9,13,17,18,21 One study searched primary and secondary care records and death registry data for codes or free-text terms relating to cirrhosis as their validation standard. 25 Ten studies evaluated codes using electronic health records 10,[13][14][15][16]18,19,[25][26][27] and seven used administrative databases, 9,11,12,17,21,23,24 the majority of which reported on in-patient and out-patient data.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Ten studies used ICD-9 codes, [9][10][11][12]15,[17][18][19]24,27 three used ICD-10 codes 14,21,22 and the remaining five used a combination of ICD-9 and/or ICD-10 codes combined with procedural codes. 13,16,23,25,26 Aside from one study, which specified that it used only the primary diagnostic code, 22 none of the remaining studies commented upon whether the code was the designated primary diagnosis code or one of the subsequent 20 diagnosis codes which can be associated with an in-patient or out-patient encounter. It is therefore assumed that the codes of interest occurred at any position.…”

Section: Quality Of Coding Setsmentioning

confidence: 99%

“…15,19 Seventeen of the studies used medical record review to validate the diagnosis of cirrhosis. [9][10][11][12][13][14][15][16][17][18][19][21][22][23][24]26,27 In these studies, the full medical record was retrieved and compared with the diagnostic codes of interest. Among the 17 studies, 13 outlined an explicit definition of their primary outcome measure.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Fifteen studies reported specific ICD codes used to define liver disease in their cohort. [9][10][11][12][13][14][15]17,18,[21][22][23][25][26][27] The remaining three studies 16,19,24 did not specify the codes, however, it was possible to obtain the information from other related studies. [28][29][30] Seven studies adopted ICD code sets which had previously been used and validated by other authors, 12,13,16,22,[24][25][26] while 11 studies developed their own selection of codes.…”

Section: Quality Of Coding Setsmentioning

confidence: 99%

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Systematic review: development of a consensus code set to identify cirrhosis in electronic health records

Shearer

González

Min

et al. 2022

Aliment Pharmacol Ther

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Background: Electronic health records (EHRs) collate longitudinal data that can be used to facilitate large-scale research in patients with cirrhosis. However, there is no consensus code set to define the presence of cirrhosis in EHR. This systematic review aims to evaluate the validity of diagnostic coding in cirrhosis and to synthesise a comprehensive set of ICD-10 codes for future EHR research.Method: MEDLINE and EMBASE databases were searched for studies that used EHR to identify cirrhosis and cirrhosis-related complications. Validated code sets were summarised, and the performance characteristics were extracted. Citation analysis was done to inform development of a consensus code set. This was then validated in a cohort of patients.Results: One thousand six hundred twenty-six records were screened, and 18 studies were identified. The positive predictive value (PPV) was the most frequently reported statistical estimate and was ≥80% in 17/18 studies. Citation analyses showed continued variation in those used in contemporary research practice. Nine codes were identified as those most frequently used in the literature and these formed the consensus code set. This was validated in diverse patient populations from Europe and North America and showed high PPV (83%-89%) and greater sensitivity for the identification of cirrhosis than the most often used code set in the recent literature. Conclusion:There is variation in code sets used to identify cirrhosis in contemporary research practice. A consensus set has been developed and validated, showing improved performance, and is proposed to align EHR study designs in cirrhosis to facilitate international collaboration and comparisons.

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