Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada

Abstract Real‐world identification of pulmonary hypertension (PH) is largely based on the use of administrative databases identified by ICD codes. This approach has not been validated. The aim of this study was to validate a diagnosis of PH and its comorbidities using ICD 9/10 codes. Health records...

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Main Authors: Don Thiwanka Wijeratne, Ahmad Housin, Katherine Lajkosz, M. Diane Lougheed, Ping Yu Xiong, David Barber, Katharine M. Doliszny, Stephen L. Archer
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Pulmonary Circulation
Subjects:
Online Access:https://doi.org/10.1002/pul2.12040
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author Don Thiwanka Wijeratne
Ahmad Housin
Katherine Lajkosz
M. Diane Lougheed
Ping Yu Xiong
David Barber
Katharine M. Doliszny
Stephen L. Archer
author_facet Don Thiwanka Wijeratne
Ahmad Housin
Katherine Lajkosz
M. Diane Lougheed
Ping Yu Xiong
David Barber
Katharine M. Doliszny
Stephen L. Archer
author_sort Don Thiwanka Wijeratne
collection DOAJ
description Abstract Real‐world identification of pulmonary hypertension (PH) is largely based on the use of administrative databases identified by ICD codes. This approach has not been validated. The aim of this study was to validate a diagnosis of PH and its comorbidities using ICD 9/10 codes. Health records from Kingston Health Sciences Centre (2010 to 2012) were abstracted to identify a diagnosis of PH. Cohort 1 patients (n = 300) were selected because they had attended a cardiology or respirology clinic without knowledge of PH status. Cohort 2 patients (n = 200) were patients with a diagnosis of PH, identified using International Classification of Diseases (ICD) codes at the time of hospitalizations (CIHI‐DAD) or emergency department (ED) visits (CIHI‐NACRS). These cohorts were combined and reviewed to validate the diagnosis of PH. These data were securely transferred to the Institute of Clinical Evaluative Sciences (ICES). The diagnosis of PH from chart abstraction was used as the gold standard. The classification of PH into WHO groups, based on chart abstraction, was also compared to classification based on ICD code‐defined comorbidities. Cohort 1 and Cohort 2 were merged to yield 449 unique patients in the combined cohort. In the combined cohort, 248 of 449 (55.2%) had a diagnosis of PH by ICD code criteria. The mean age of this PH group was 70 years, and the majority were females (65.5%). One hospitalization or ED visit resulting in a diagnostic code for PH had a sensitivity of 73% and a specificity of 99% for a confirmed PH diagnosis on chart abstraction. When WHO classification by chart abstraction and ICD codes for comorbidities were compared, there was 87% agreement. Identification of PH and its comorbidities using ICD codes is a valid approach, and this single‐center study supports its application to identify PH.
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spelling doaj.art-ca89536f3b074533860176aaa25597d72022-12-22T02:57:49ZengWileyPulmonary Circulation2045-89402022-01-01121n/an/a10.1002/pul2.12040Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, CanadaDon Thiwanka Wijeratne0Ahmad Housin1Katherine Lajkosz2M. Diane Lougheed3Ping Yu Xiong4David Barber5Katharine M. Doliszny6Stephen L. Archer7Department of Medicine Queen's University Kingston Ontario CanadaDepartment of Medicine Queen's University Kingston Ontario CanadaInstitute of Clinical Evaluative Sciences Queen's University Kingston Ontario CanadaDepartment of Medicine Queen's University Kingston Ontario CanadaDepartment of Medicine Queen's University Kingston Ontario CanadaDepartment of Medicine Queen's University Kingston Ontario CanadaDepartment of Medicine Queen's University Kingston Ontario CanadaDepartment of Medicine Queen's University Kingston Ontario CanadaAbstract Real‐world identification of pulmonary hypertension (PH) is largely based on the use of administrative databases identified by ICD codes. This approach has not been validated. The aim of this study was to validate a diagnosis of PH and its comorbidities using ICD 9/10 codes. Health records from Kingston Health Sciences Centre (2010 to 2012) were abstracted to identify a diagnosis of PH. Cohort 1 patients (n = 300) were selected because they had attended a cardiology or respirology clinic without knowledge of PH status. Cohort 2 patients (n = 200) were patients with a diagnosis of PH, identified using International Classification of Diseases (ICD) codes at the time of hospitalizations (CIHI‐DAD) or emergency department (ED) visits (CIHI‐NACRS). These cohorts were combined and reviewed to validate the diagnosis of PH. These data were securely transferred to the Institute of Clinical Evaluative Sciences (ICES). The diagnosis of PH from chart abstraction was used as the gold standard. The classification of PH into WHO groups, based on chart abstraction, was also compared to classification based on ICD code‐defined comorbidities. Cohort 1 and Cohort 2 were merged to yield 449 unique patients in the combined cohort. In the combined cohort, 248 of 449 (55.2%) had a diagnosis of PH by ICD code criteria. The mean age of this PH group was 70 years, and the majority were females (65.5%). One hospitalization or ED visit resulting in a diagnostic code for PH had a sensitivity of 73% and a specificity of 99% for a confirmed PH diagnosis on chart abstraction. When WHO classification by chart abstraction and ICD codes for comorbidities were compared, there was 87% agreement. Identification of PH and its comorbidities using ICD codes is a valid approach, and this single‐center study supports its application to identify PH.https://doi.org/10.1002/pul2.12040health administrative datapopulation studiespulmonary hypertensionvalidation
spellingShingle Don Thiwanka Wijeratne
Ahmad Housin
Katherine Lajkosz
M. Diane Lougheed
Ping Yu Xiong
David Barber
Katharine M. Doliszny
Stephen L. Archer
Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada
Pulmonary Circulation
health administrative data
population studies
pulmonary hypertension
validation
title Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada
title_full Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada
title_fullStr Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada
title_full_unstemmed Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada
title_short Using health administrative data to identify patients with pulmonary hypertension: A single center, proof of concept validation study in Ontario, Canada
title_sort using health administrative data to identify patients with pulmonary hypertension a single center proof of concept validation study in ontario canada
topic health administrative data
population studies
pulmonary hypertension
validation
url https://doi.org/10.1002/pul2.12040
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