Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan
Te-Wei Ho,1,2 Sheng-Yuan Ruan,3 Chun-Ta Huang,3,4 Yi-Ju Tsai,5 Feipei Lai,1 Chong-Jen Yu3 1Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan; 2Department of Surgery, College of Medicine...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-10-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/validity-of-icd9-cm-codes-to-diagnose-chronic-obstructive-pulmonary-di-peer-reviewed-article-COPD |
| _version_ | 1818512830503059456 |
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| author | Ho TW Ruan SY Huang CT Tsai YJ Lai F Yu CJ |
| author_facet | Ho TW Ruan SY Huang CT Tsai YJ Lai F Yu CJ |
| author_sort | Ho TW |
| collection | DOAJ |
| description | Te-Wei Ho,1,2 Sheng-Yuan Ruan,3 Chun-Ta Huang,3,4 Yi-Ju Tsai,5 Feipei Lai,1 Chong-Jen Yu3 1Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan; 2Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan; 5Graduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan Purpose: Claim data from Taiwan’s National Health Insurance (NHI) database have previously been utilized in the study of COPD. However, there are limited data on the positive predictive value of claim data for COPD diagnosis. Therefore, this study aimed to characterize and validate the COPD cohort identified from the NHI research database.Methods: This cross-sectional study compared records from claim data with those from a medical center. From 2007 to 2014, a COPD cohort was constructed from claim data using ICD9-CM codes for COPD. The diagnostic positive predictive value of these data was assessed with reference to physician-verified COPD. In addition, a multivariate logistic regression model was built to identify independent factors associated with the positive predictive value of COPD diagnosis by claim data.Results: During the 8-year study period, a total of 12,127 subjects met the criterion of having two or more outpatient codes in 1 year or one or more inpatient COPD codes in their claim data. Of this total, the diagnosis of COPD was verified by physicians in 7,701 (63.5%) subjects. Applying a more stringent criterion – three or more outpatient codes or two or more inpatient codes – improved the diagnostic positive predictive value to 72.2%. Age ≥65 years and a claim for spirometry were the two most important factors associated with the positive predictive value of claim-data-defined COPD. Adding spirometry testing to diagnostic ICD9-CM codes for COPD increased the positive predictive value to 84.6%.Conclusion: This study emphasizes the importance of validation of disease-specific diagnosis prior to applying an administrative database in clinical studies. It also indicates the limitation of ICD9-CM codes alone in recognizing COPD patients within the NHI research database. Keywords: chronic obstructive pulmonary disease, database, International Classification of Diseases code, Taiwan, validity |
| first_indexed | 2024-12-10T23:52:33Z |
| format | Article |
| id | doaj.art-c7b261ecd612412aa9213dc93ecccd00 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-10T23:52:33Z |
| publishDate | 2018-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-c7b261ecd612412aa9213dc93ecccd002022-12-22T01:28:43ZengDove Medical PressInternational Journal of COPD1178-20052018-10-01Volume 133055306341049Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in TaiwanHo TWRuan SYHuang CTTsai YJLai FYu CJTe-Wei Ho,1,2 Sheng-Yuan Ruan,3 Chun-Ta Huang,3,4 Yi-Ju Tsai,5 Feipei Lai,1 Chong-Jen Yu3 1Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan; 2Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan; 5Graduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan Purpose: Claim data from Taiwan’s National Health Insurance (NHI) database have previously been utilized in the study of COPD. However, there are limited data on the positive predictive value of claim data for COPD diagnosis. Therefore, this study aimed to characterize and validate the COPD cohort identified from the NHI research database.Methods: This cross-sectional study compared records from claim data with those from a medical center. From 2007 to 2014, a COPD cohort was constructed from claim data using ICD9-CM codes for COPD. The diagnostic positive predictive value of these data was assessed with reference to physician-verified COPD. In addition, a multivariate logistic regression model was built to identify independent factors associated with the positive predictive value of COPD diagnosis by claim data.Results: During the 8-year study period, a total of 12,127 subjects met the criterion of having two or more outpatient codes in 1 year or one or more inpatient COPD codes in their claim data. Of this total, the diagnosis of COPD was verified by physicians in 7,701 (63.5%) subjects. Applying a more stringent criterion – three or more outpatient codes or two or more inpatient codes – improved the diagnostic positive predictive value to 72.2%. Age ≥65 years and a claim for spirometry were the two most important factors associated with the positive predictive value of claim-data-defined COPD. Adding spirometry testing to diagnostic ICD9-CM codes for COPD increased the positive predictive value to 84.6%.Conclusion: This study emphasizes the importance of validation of disease-specific diagnosis prior to applying an administrative database in clinical studies. It also indicates the limitation of ICD9-CM codes alone in recognizing COPD patients within the NHI research database. Keywords: chronic obstructive pulmonary disease, database, International Classification of Diseases code, Taiwan, validity https://www.dovepress.com/validity-of-icd9-cm-codes-to-diagnose-chronic-obstructive-pulmonary-di-peer-reviewed-article-COPDchronic obstructive pulmonary diseasedatabaseInternational Classification of Diseases codeTaiwanvalidity |
| spellingShingle | Ho TW Ruan SY Huang CT Tsai YJ Lai F Yu CJ Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan International Journal of COPD chronic obstructive pulmonary disease database International Classification of Diseases code Taiwan validity |
| title | Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan |
| title_full | Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan |
| title_fullStr | Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan |
| title_full_unstemmed | Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan |
| title_short | Validity of ICD9-CM codes to diagnose chronic obstructive pulmonary disease from National Health Insurance claim data in Taiwan |
| title_sort | validity of icd9 cm codes to diagnose chronic obstructive pulmonary disease from national health insurance claim data in taiwan |
| topic | chronic obstructive pulmonary disease database International Classification of Diseases code Taiwan validity |
| url | https://www.dovepress.com/validity-of-icd9-cm-codes-to-diagnose-chronic-obstructive-pulmonary-di-peer-reviewed-article-COPD |
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