Luke Rudmik1,2, Yuan Xu3, Edward Kukec4, Mingfu Liu4, Stafford Dean4, Hude Quan3. 1. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. lukerudmik@gmail.com. 2. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. lukerudmik@gmail.com. 3. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 4. Data Integration, Measurement and Reporting (DIMR), Alberta Health Services, Calgary, Alberta, Canada.
Abstract
BACKGROUND: Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims. METHODS: A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015. The proportion of CRS ICD-9-coded claims (473.x and 471.x) for each of these 200 patients were reviewed and the validity of 7 different ICD-9-based coding algorithms was evaluated. RESULTS: The CRS case definition of ≥2 claims with a CRS ICD-9 code (471.x or 473.x) within 2 years of the reference case provides a balanced validity with a sensitivity of 77% and specificity of 79%. Applying this CRS case definition to the claims database produced a CRS cohort of 51,000 patients with characteristics that were consistent with published demographics and rates of comorbid asthma, allergic rhinitis, and depression. CONCLUSION: This study has validated several coding algorithms; based on the results a case definition of ≥2 physician claims of CRS (ICD-9 of 471.x or 473.x) within 2 years provides an optimal level of validity. Future studies will need to validate this administrative case definition from different health system perspectives and using larger retrospective chart reviews from multiple providers.
BACKGROUND: Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims. METHODS: A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015. The proportion of CRS ICD-9-coded claims (473.x and 471.x) for each of these 200 patients were reviewed and the validity of 7 different ICD-9-based coding algorithms was evaluated. RESULTS: The CRS case definition of ≥2 claims with a CRS ICD-9 code (471.x or 473.x) within 2 years of the reference case provides a balanced validity with a sensitivity of 77% and specificity of 79%. Applying this CRS case definition to the claims database produced a CRS cohort of 51,000 patients with characteristics that were consistent with published demographics and rates of comorbid asthma, allergic rhinitis, and depression. CONCLUSION: This study has validated several coding algorithms; based on the results a case definition of ≥2 physician claims of CRS (ICD-9 of 471.x or 473.x) within 2 years provides an optimal level of validity. Future studies will need to validate this administrative case definition from different health system perspectives and using larger retrospective chart reviews from multiple providers.
Authors: Caroline S Clarke; Elizabeth Williamson; Spiros Denaxas; James R Carpenter; Mike Thomas; Helen Blackshaw; Anne G M Schilder; Carl M Philpott; Claire Hopkins; Stephen Morris Journal: BMJ Open Date: 2022-02-08 Impact factor: 2.692
Authors: Robert Naclerio; Fuad Baroody; Claus Bachert; Benjamin Bleier; Larry Borish; Erica Brittain; Geoffrey Chupp; Anat Fisher; Wytske Fokkens; Philippe Gevaert; David Kennedy; Jean Kim; Tanya M Laidlaw; Jake J Lee; Jay F Piccirillo; Jayant M Pinto; Lauren T Roland; Robert P Schleimer; Rodney J Schlosser; Julie M Schwaninger; Timothy L Smith; Bruce K Tan; Ming Tan; Elina Toskala; Sally Wenzel; Alkis Togias Journal: J Allergy Clin Immunol Pract Date: 2020-03-04