Abstract
Objective:
To characterise the relationship between ICD code-based (i.e. physician diagnosis-based) and criteria-based asthma ascertainment.
Methods:
We compared identification of children with asthma between criteria-based medical record review for asthma ascertainment and an ICD-9 code-based approach. We determined the agreement rate and validity index of ICD code-based asthma ascertainment using asthma status by medical record review as a gold standard.
Results:
Of the 115 study subjects, the agreement between medical record review and ICD-9 coding was 81.6% with a kappa value of 0.28 (P<0.0001). Sensitivity, specificity, positive and negative predictive values for ICD-9 code were 24.0%, 97.8%, 75.0%, and 82.0%, respectively, using criteria for asthma by medical record review as gold standard.
Conclusions:
ICD code-based asthma ascertainment appears to under-identify children with asthma compared to criteria-based medical record review. ICD codes may be useful for etiologic research but may not be suitable for surveillance of asthma epidemiology.
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The study investigators have nothing to disclose that poses a conflict of interest.
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Juhn, Y., Kung, A., Voigt, R. et al. Characterisation of children's asthma status by ICD-9 code and criteria-based medical record review. Prim Care Respir J 20, 79–83 (2011). https://doi.org/10.4104/pcrj.2010.00076
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DOI: https://doi.org/10.4104/pcrj.2010.00076