Validity of International Classification of Diseases (ICD) coding for dengue infections in hospital discharge records in Malaysia

Abstract

BackgroundHospitalization due to dengue illness is an important measure of dengue morbidity. However, limited studies are based on administrative database because the validity of the diagnosis codes is unknown. We validated the International Classification of Diseases, 10th revision (ICD) diagnosis coding for dengue infections in the Malaysian Ministry of Health’s (MOH) hospital discharge database.MethodsThis validation study involves retrospective review of available hospital discharge records and hand-search medical records for years 2010 and 2013. We randomly selected 3219 hospital discharge records coded with dengue and non-dengue infections as their discharge diagnoses from the national hospital discharge database. We then randomly sampled 216 and 144 records for patients with and without codes for dengue respectively, in keeping with their relative frequency in the MOH database, for chart review. The ICD codes for dengue were validated against lab–based diagnostic standard (NS1 or IgM).ResultsThe ICD-10-CM codes for dengue had a sensitivity of 94%, modest specificity of 83%, positive predictive value of 87% and negative predictive value 92%. These results were stable between 2010 and 2013. However, its specificity decreased substantially when patients manifested with bleeding or low platelet count.ConclusionThe diagnostic performance of the ICD codes for dengue in the MOH’s hospital discharge database is adequate for use in health services research on dengue.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3104-z) contains supplementary material, which is available to authorized users.

The Burden of Arboviral Infections in the Military Health System 2012–2019

“…This contrasts with a prior study in Malaysia, which demonstrated a high sensitivity of ICD coding for DNV. 20 The discordance is likely explained by the difference in the pre-test probability of infection in the studied populations, with the overall exposure risk of our returning traveler population being lower than that of the indigenous population. Similarly, a surveillance study in Colombia suggests that arboviral infections are underdiagnosed within its national health system.…”

“…Our study supports prior findings that both VFR travel and military travel are associated with an increased risk of travel-related infection, including arboviruses. 5,10,20 Based on case definitions, laboratory evidence of infection is required for confirmed and probable cases of DNV, ZIKV, and CHIKV, but not for suspected cases. We found that a majority of reviewed DNV, ZIKV, and CHIKV codes incorporated laboratory evaluation.…”

Incidence of dementia after dengue fever: Results of a longitudinal population‐based study

“…*) and dengue hemorrhagic fever (ICD‐9‐CM 065.4). Using ICD coding as a substitute to enroll cases in medical records might not identify all cases with dengue fever, but they are regarded as an alternative, 13 and the algorithm has been used in previous studies 14 . The index date was the dengue fever diagnosis date.…”

A Systematic Literature Review on Online Medical Services in Malaysia

“…The majority of disease-infected patients are asymptomatic and suffer low health consequences and prevalence are measure the frequency of disease rather than measure the disease burden [21]. The study in the review suggested the dengue infection that for developing and conducting research about the dengue virus in Malaysia, the government must provide data of infected dengue patients to researchers for future recommendations and batter planning medication to control virus [22]. About dengue disease, principle complication is vascular permeability, that is decrease with age.…”

“…About dengue disease, principle complication is vascular permeability, that is decrease with age. Signs of plasma leakage and decrease in platelet are more prevalent in infants, followed by children and adults and related to positive dengue diagnose in the laboratory [22].…”