Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register
Abstract Background About 50% of patients with Crohn’s disease (CD) and about 20% of those with ulcerative colitis (UC) undergo surgery at some point during the course of the disease. The diagnostic validity of the Swedish National Patient Register (NPR) has previously been shown to be high for infl...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-11-01
|
| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12911-019-0948-z |
| _version_ | 1828783653844418560 |
|---|---|
| author | Anders Forss Pär Myrelid Ola Olén Åsa H. Everhov Caroline Nordenvall Jonas Halfvarson Jonas F. Ludvigsson |
| author_facet | Anders Forss Pär Myrelid Ola Olén Åsa H. Everhov Caroline Nordenvall Jonas Halfvarson Jonas F. Ludvigsson |
| author_sort | Anders Forss |
| collection | DOAJ |
| description | Abstract Background About 50% of patients with Crohn’s disease (CD) and about 20% of those with ulcerative colitis (UC) undergo surgery at some point during the course of the disease. The diagnostic validity of the Swedish National Patient Register (NPR) has previously been shown to be high for inflammatory bowel disease (IBD), but there are little data on the validity of IBD-related surgical procedure codes. Methods Using patient chart data as the gold standard, surgical procedure codes registered between 1966 and 2014 in the NPR were abstracted and validated in 262 randomly selected patients with a medical diagnosis of IBD. Of these, 53 patients had reliable data about IBD-related surgery. The positive predictive value (PPV), sensitivity and specificity of the surgical procedure codes were calculated. Results In total, 158 surgical procedure codes were registered in the NPR. One hundred fifty-five of these, representing 60 different procedure codes, were also present in the patient charts and validated using a standardized form. Of the validated codes 153/155 were concordant with the patient charts, corresponding to a PPV of 96.8% (95%CI = 93.9–99.1). Stratified in abdominal, perianal and other surgery, the corresponding PPVs were 94.1% (95%CI = 88.7–98.6), 100% (95%CI = 100–100) and 98.1% (95%CI = 93.1–100), respectively. Of 164 surgical procedure codes in the validated patient charts, 155 were registered in the NPR, corresponding to a sensitivity of the surgical procedure codes of 94.5% (95%CI = 89.6–99.3). The specificity of the NPR was 98.5% (95%CI = 97.6–100). Conclusions Data on IBD-related surgical procedure codes are reliable, with the Swedish National Patient Register showing a high sensitivity and specificity for such surgery. |
| first_indexed | 2024-12-11T23:16:09Z |
| format | Article |
| id | doaj.art-8ba870b8ab5c4bbb8f7dfc32dc888278 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-12-11T23:16:09Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-8ba870b8ab5c4bbb8f7dfc32dc8882782022-12-22T00:46:31ZengBMCBMC Medical Informatics and Decision Making1472-69472019-11-011911810.1186/s12911-019-0948-zValidating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient RegisterAnders Forss0Pär Myrelid1Ola Olén2Åsa H. Everhov3Caroline Nordenvall4Jonas Halfvarson5Jonas F. Ludvigsson6Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Clinical and Experimental Medicine, Faculty of Health, Linköping University, Department of Surgery, Linköping University HospitalClinical Epidemiology Unit, Department of Medicine Solna, Karolinska InstitutetClinical Epidemiology Unit, Department of Medicine Solna, Karolinska InstitutetDepartment of Molecular Medicine and Surgery, Karolinska InstitutetDepartment of Gastroenterology, Faculty of Medicine and Health, Örebro UniversityDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetAbstract Background About 50% of patients with Crohn’s disease (CD) and about 20% of those with ulcerative colitis (UC) undergo surgery at some point during the course of the disease. The diagnostic validity of the Swedish National Patient Register (NPR) has previously been shown to be high for inflammatory bowel disease (IBD), but there are little data on the validity of IBD-related surgical procedure codes. Methods Using patient chart data as the gold standard, surgical procedure codes registered between 1966 and 2014 in the NPR were abstracted and validated in 262 randomly selected patients with a medical diagnosis of IBD. Of these, 53 patients had reliable data about IBD-related surgery. The positive predictive value (PPV), sensitivity and specificity of the surgical procedure codes were calculated. Results In total, 158 surgical procedure codes were registered in the NPR. One hundred fifty-five of these, representing 60 different procedure codes, were also present in the patient charts and validated using a standardized form. Of the validated codes 153/155 were concordant with the patient charts, corresponding to a PPV of 96.8% (95%CI = 93.9–99.1). Stratified in abdominal, perianal and other surgery, the corresponding PPVs were 94.1% (95%CI = 88.7–98.6), 100% (95%CI = 100–100) and 98.1% (95%CI = 93.1–100), respectively. Of 164 surgical procedure codes in the validated patient charts, 155 were registered in the NPR, corresponding to a sensitivity of the surgical procedure codes of 94.5% (95%CI = 89.6–99.3). The specificity of the NPR was 98.5% (95%CI = 97.6–100). Conclusions Data on IBD-related surgical procedure codes are reliable, with the Swedish National Patient Register showing a high sensitivity and specificity for such surgery.http://link.springer.com/article/10.1186/s12911-019-0948-zEpidemiologyInflammatory bowel diseaseValidationNational Patient RegisterProcedure code |
| spellingShingle | Anders Forss Pär Myrelid Ola Olén Åsa H. Everhov Caroline Nordenvall Jonas Halfvarson Jonas F. Ludvigsson Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register BMC Medical Informatics and Decision Making Epidemiology Inflammatory bowel disease Validation National Patient Register Procedure code |
| title | Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register |
| title_full | Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register |
| title_fullStr | Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register |
| title_full_unstemmed | Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register |
| title_short | Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register |
| title_sort | validating surgical procedure codes for inflammatory bowel disease in the swedish national patient register |
| topic | Epidemiology Inflammatory bowel disease Validation National Patient Register Procedure code |
| url | http://link.springer.com/article/10.1186/s12911-019-0948-z |
| work_keys_str_mv | AT andersforss validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister AT parmyrelid validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister AT olaolen validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister AT asaheverhov validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister AT carolinenordenvall validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister AT jonashalfvarson validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister AT jonasfludvigsson validatingsurgicalprocedurecodesforinflammatoryboweldiseaseintheswedishnationalpatientregister |