TY - JOUR
T1 - Validation of ICD-9-CM diagnostic codes for inflammatory bowel disease among veterans
AU - Thirumurthi, Selvi
AU - Chowdhury, Reezwana
AU - Richardson, Peter
AU - Abraham, Neena S.
N1 - Funding Information:
Acknowledgments This material is based upon work supported (wholly or in part) by the Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. It was also supported in part by the Houston VA HSR&D Center of Excellence (HFP90-020). Dr. Abraham is supported by an American Gastroenterological Association Foundation-Sucampo-Association of Specialty Professors Designated Research Award in Geriatric Gastroenterology, and a Merit Review Award from the Department of Veterans Affairs (VA IIR08-028). This work was presented in part at the American College of Gastroenterology Annual Meeting, Philadelphia, Pennsylvania, October 2007. Dr. Thirumurthi has received research funding from UCB Pharmaceuticals.
PY - 2010/9
Y1 - 2010/9
N2 - Background: Inflammatory bowel disease (IBD) is well described among young whites and less so among the elderly and non-whites. Population-level data is required to assess outcomes among minority groups. Aim: To validate diagnostic codes for IBD from the Department of Veterans Affairs. Methods: National databases were used to identify local patients with Crohn's disease (CD) and ulcerative colitis (UC), the extra-intestinal manifestations and surgical procedures associated with IBD. Diagnosis was confirmed by manual chart abstraction. Multivariable logistic regression was used to derive diagnostic algorithms for CD and UC, which were then validated in an independent cohort. Results: The test cohort of 3,827 patients (1,316 potential cases, 2,511 random controls) was predominantly male (94%), white (56%), and of age of 58 (standard deviation 15). The positive predictive value (PPV) of CD codes was superior (88-100%) to UC (50-93%). The accuracy of extra-intestinal manifestations and surgeries was poor (PPV 0-29%). ICD-9-CM code 555.x without 560.9 had a PPV of 91% for CD in the validation cohort. Code 556.x with age, gender, and race factors was highly predictive of UC (c-statistic 0.9, PPV of 81%). Conclusion: VA administrative data can diagnose elderly and non-white patients with IBD.
AB - Background: Inflammatory bowel disease (IBD) is well described among young whites and less so among the elderly and non-whites. Population-level data is required to assess outcomes among minority groups. Aim: To validate diagnostic codes for IBD from the Department of Veterans Affairs. Methods: National databases were used to identify local patients with Crohn's disease (CD) and ulcerative colitis (UC), the extra-intestinal manifestations and surgical procedures associated with IBD. Diagnosis was confirmed by manual chart abstraction. Multivariable logistic regression was used to derive diagnostic algorithms for CD and UC, which were then validated in an independent cohort. Results: The test cohort of 3,827 patients (1,316 potential cases, 2,511 random controls) was predominantly male (94%), white (56%), and of age of 58 (standard deviation 15). The positive predictive value (PPV) of CD codes was superior (88-100%) to UC (50-93%). The accuracy of extra-intestinal manifestations and surgeries was poor (PPV 0-29%). ICD-9-CM code 555.x without 560.9 had a PPV of 91% for CD in the validation cohort. Code 556.x with age, gender, and race factors was highly predictive of UC (c-statistic 0.9, PPV of 81%). Conclusion: VA administrative data can diagnose elderly and non-white patients with IBD.
KW - Crohn's disease
KW - Elderly
KW - ICD-9-CM code
KW - Positive predictive value
KW - Ulcerative colitis
KW - Validation studies
KW - Veterans
UR - https://www.scopus.com/pages/publications/77956187753
UR - https://www.scopus.com/pages/publications/77956187753#tab=citedBy
U2 - 10.1007/s10620-009-1074-z
DO - 10.1007/s10620-009-1074-z
M3 - Article
C2 - 20033847
AN - SCOPUS:77956187753
SN - 0163-2116
VL - 55
SP - 2592
EP - 2598
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 9
ER -