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ICD-10 codes are a valid tool for identification of pneumonia in hospitalized patients aged ⩾65 years

  • S. A. SKULL (a1) (a2), R. M. ANDREWS (a2), G. B. BYRNES (a3), D. A. CAMPBELL (a3) (a4), T. M. NOLAN (a3), G. V. BROWN (a5) and H. A. KELLY (a3) (a6)...

Summary

This study examines the validity of using ICD-10 codes to identify hospitalized pneumonia cases. Using a case-cohort design, subjects were randomly selected from monthly cohorts of patients aged ⩾65 years discharged from April 2000 to March 2002 from two large tertiary Australian hospitals. Cases had ICD-10-AM codes J10–J18 (pneumonia); the cohort sample was randomly selected from all discharges, frequency matched to cases by month. Codes were validated against three comparators: medical record notation of pneumonia, chest radiograph (CXR) report and both. Notation of pneumonia was determined for 5098/5101 eligible patients, and CXR reports reviewed for 3349/3464 (97%) patients with a CXR. Coding performed best against notation of pneumonia: kappa 0·95, sensitivity 97·8% (95% CI 97·1–98·3), specificity 96·9% (95% CI 96·2–97·5), positive predictive value (PPV) 96·2% (95% CI 95·4–97·0) and negative predictive value (NPV) 98·2% (95% CI 97·6–98·6). When medical record notation of pneumonia is used as the standard, ICD-10 codes are a valid method for retrospective ascertainment of hospitalized pneumonia cases and appear superior to use of complexes of symptoms and signs, or radiology reports.

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Copyright

Corresponding author

*Author for correspondence: Dr S. A. Skull, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, Australia 3052. (Email: saskull@unimelb.edu.au)

References

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Smith, PR. What diagnostic tests are needed for community-acquired pneumonia? Medical Clinics of North America 2001; 85: 13811396.
Fine, MJ, Chowdhry, T, Ketema, A. Outpatient management of community-acquired pneumonia. Hospital Practice (Office Edition) 1998; 33: 123133.
Metlay, JP, et al. Influence of age on symptoms at presentation in patients with community-acquired pneumonia. Archives of Internal Medicine 1997; 157: 14531459.
Marrie, TJ, et al. Community-acquired pneumonia requiring hospitalization. Is it different in the elderly? Journal of the American Geriatrics Society 1985; 33: 671680.
Albaum, MN, et al. Interobserver reliability of the chest radiograph in community-acquired pneumonia. PORT Investigators. Chest 1996; 110: 343350.
Syrjala, H, et al. High-resolution computed tomography for the diagnosis of community-acquired pneumonia. Clinical Infectious Diseases 1998; 27: 358363.
Nichol, KL, et al. The health and economic benefits associated with pneumococcal vaccination of elderly persons with chronic lung disease. Archives of Internal Medicine 1999; 159: 24372442.
Christenson, B, et al. Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in adults aged 65 years or older: a prospective study. Lancet 2001; 357: 10081011.
Dear, K, et al. Vaccines for preventing pneumococcal infection in adults [Cochrane Review]. The Cochrane Database of Systematic Reviews (http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000422/frame.html). Accessed 24 February 2004.
Vila-Córcoles, A, et al. Protective effect of pneumococcal vaccine against death by pneumonia in elderly subjects. European Respiratory Journal 2005; 26: 10861091.
Fisman, DN, et al. Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia. Clinical Infectious Diseases 2006; 42: 10931101.
World Health Organization. International Classification of Diseases (ICD). WHO (http://www.who.int/classifications/icd/en/). Accessed 13 August 2006.
Marrie, TJ, Durant, H, Sealy, E. Pneumonia – the quality of medical records data. Medical Care 1987; 25: 2024.
Whittle, J, et al. Community-acquired pneumonia: can it be defined with claims data? American Journal of Medical Quality 1997; 12: 187193.
Guevara, RE, et al. Accuracy of ICD-9-CM codes in detecting community-acquired pneumococcal pneumonia for incidence and vaccine efficacy studies. American Journal of Epidemiology 1999; 149: 282289.
Comstock, GW. Evaluating vaccination effectiveness and vaccine efficacy by means of case-control studies. Epidemiologic Reviews 1994; 16: 7789.
Wacholder, S. Practical considerations in choosing between the case-cohort and nested case-control designs. Epidemiology 1991; 2: 155158.
National Centre for Classification in Health. International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification, 1st edn. Sydney: University of Sydney, 1998.
Department of Human Services Victoria. Victorian Inpatient Medical Database. Performance Reporting & Analysis, Department of Human Services Victoria. Accessed 15 May 2004.
The National Centre for Classification in Health. ICD-10-AM Australian Coding Standards, 2nd edn. Sydney: The National Centre for Classification in Health, 2000.
Last, JM. A Dictionary of Epidemiology, 3rd edn. New York: Oxford University Press, 1995.
Neill, AM, et al. Community acquired pneumonia: aetiology and usefulness of severity criteria on admission. Thorax 1996; 51: 10101016.
Szklo, M, Nieto, FJ. Quality assurance and control: the kappa statistic. In: Szklo, M, Nieto, FJ eds. Epidemiology. Beyond the Basics. Gaithersburg: Aspen Publishers; 2000, pp. 343406.
Intercooled Stata 9.1 for Windows. Computer program, version 9.1. College Station, TX: StataCorp LP, 2005.
Watts, CG, et al. Establishing thresholds for influenza surveillance in Victoria. Australia and New Zealand Journal of Public Health 2003; 27: 409412.
Commission on Professional and Hospital Activities. International Classification of Diseases, 9th Revision, Clinical Modification, Vol 1. Ann Arbor, Michigan, 1980.
Fine, MJ, et al. Validation of a pneumonia prognostic index using the MedisGroups comparative hospital database. American Journal of Medicine 1993; 94: 153159.
Aronsky, D, et al. Accuracy of administrative data for identifying patients with pneumonia. American Journal of Medical Quality 2005; 20: 319328.
Aronsky, D, Chan, KJ, Haug, PJ. Evaluation of a computerized diagnostic decision support system for patients with pneumonia: study design considerations. Journal of the American Medical Informatics Association 2001; 8: 473485.
Ansaldi, F, et al. Effectiveness of a 23-valent polysaccharide vaccine in preventing pneumonia and non-invasive pneumococcal infection in elderly people: a large-scale retrospective cohort study. Journal of International Medical Research 2005; 33: 490500.
Cherian, T, et al. Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies. Bulletin of the World Health Organization 2005; 83: 353359.

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