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Validity of administrative data in recording sepsis: a systematic review.

Jolley RJ, Sawka KJ, Yergens DW, Quan H, Jetté N, Doig CJ - Crit Care (2015)

Bottom Line: The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%.Other tests of diagnostic accuracy were reported only in some studies.Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. rjjolley@ucalgary.ca.

ABSTRACT

Introduction: Administrative health data have been used to study sepsis in large population-based studies. The validity of these study findings depends largely on the quality of the administrative data source and the validity of the case definition used. We systematically reviewed the literature to assess the validity of case definitions of sepsis used with administrative data.

Methods: Embase and MEDLINE were searched for published articles with International Classification of Diseases (ICD) coded data used to define sepsis. Abstracts and full-text articles were reviewed in duplicate. Data were abstracted from all eligible full-text articles, including ICD-9- and/or ICD-10-based case definitions, sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).

Results: Of 2,317 individual studies identified, 12 full-text articles met all eligibility criteria. A total of 38 sepsis case definitions were tested, which included over 130 different ICD codes. The most common ICD-9 codes were 038.x, 790.7 and 995.92, and the most common ICD-10 codes were A40.x and A41.x. The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%. Other tests of diagnostic accuracy were reported only in some studies. Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.

Conclusions: The validity of administrative data in recording sepsis varied substantially across individual studies and ICD definitions. Our work may serve as a reference point for consensus towards an improved and harmonized ICD-coded definition of sepsis.

No MeSH data available.


Related in: MedlinePlus

Flow diagram for study screening and article inclusion. ICD, International Classification of Diseases.
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Fig1: Flow diagram for study screening and article inclusion. ICD, International Classification of Diseases.

Mentions: Of 2,317 abstracts reviewed, 96 fulfilled eligibility criteria for full-text review. Amongst these articles, the κ score for inter-rater agreement was 0.87, resulting in near-perfect agreement [18]. Twelve articles met all eligibility criteria and were included in the study [12,19-29] (Figure 1). The characteristics of the studies are shown in Table 1. All 12 studies examined hospital discharge abstract data (also called ‘inpatient administrative health data’ or ‘inpatient claims administrative dataset’). Eight of the twelve studies were performed in the United States [12,19,21,23,25,27-29], one in Australia [22], one in Denmark [24], one in Sweden [20] and one in Canada [26]. Publication dates ranged from 1998 to 2014. Seven studies examined ICD-9-CM codes, one examined only ICD-9, one examined both ICD-9 and ICD-10 codes, one study examined ICD-10, one study examined the ICD-10 Danish version and one study examined ICD-10-AM (Australian Modification) codes. The studies varied considerably in sample size (ranging from 34 to 4,181) and had heterogeneity in patients studied, including highly selective populations (rheumatoid arthritis) or sepsis clinical trial patients, to intensive care unit (ICU)-specific, general medical patients or surgical patients. The clinical definition of sepsis varied across studies but generally followed the ACCP/SCCM consensus conference definition’s clinical criteria closely [30].Figure 1


Validity of administrative data in recording sepsis: a systematic review.

Jolley RJ, Sawka KJ, Yergens DW, Quan H, Jetté N, Doig CJ - Crit Care (2015)

Flow diagram for study screening and article inclusion. ICD, International Classification of Diseases.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403835&req=5

Fig1: Flow diagram for study screening and article inclusion. ICD, International Classification of Diseases.
Mentions: Of 2,317 abstracts reviewed, 96 fulfilled eligibility criteria for full-text review. Amongst these articles, the κ score for inter-rater agreement was 0.87, resulting in near-perfect agreement [18]. Twelve articles met all eligibility criteria and were included in the study [12,19-29] (Figure 1). The characteristics of the studies are shown in Table 1. All 12 studies examined hospital discharge abstract data (also called ‘inpatient administrative health data’ or ‘inpatient claims administrative dataset’). Eight of the twelve studies were performed in the United States [12,19,21,23,25,27-29], one in Australia [22], one in Denmark [24], one in Sweden [20] and one in Canada [26]. Publication dates ranged from 1998 to 2014. Seven studies examined ICD-9-CM codes, one examined only ICD-9, one examined both ICD-9 and ICD-10 codes, one study examined ICD-10, one study examined the ICD-10 Danish version and one study examined ICD-10-AM (Australian Modification) codes. The studies varied considerably in sample size (ranging from 34 to 4,181) and had heterogeneity in patients studied, including highly selective populations (rheumatoid arthritis) or sepsis clinical trial patients, to intensive care unit (ICU)-specific, general medical patients or surgical patients. The clinical definition of sepsis varied across studies but generally followed the ACCP/SCCM consensus conference definition’s clinical criteria closely [30].Figure 1

Bottom Line: The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%.Other tests of diagnostic accuracy were reported only in some studies.Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. rjjolley@ucalgary.ca.

ABSTRACT

Introduction: Administrative health data have been used to study sepsis in large population-based studies. The validity of these study findings depends largely on the quality of the administrative data source and the validity of the case definition used. We systematically reviewed the literature to assess the validity of case definitions of sepsis used with administrative data.

Methods: Embase and MEDLINE were searched for published articles with International Classification of Diseases (ICD) coded data used to define sepsis. Abstracts and full-text articles were reviewed in duplicate. Data were abstracted from all eligible full-text articles, including ICD-9- and/or ICD-10-based case definitions, sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).

Results: Of 2,317 individual studies identified, 12 full-text articles met all eligibility criteria. A total of 38 sepsis case definitions were tested, which included over 130 different ICD codes. The most common ICD-9 codes were 038.x, 790.7 and 995.92, and the most common ICD-10 codes were A40.x and A41.x. The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%. Other tests of diagnostic accuracy were reported only in some studies. Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.

Conclusions: The validity of administrative data in recording sepsis varied substantially across individual studies and ICD definitions. Our work may serve as a reference point for consensus towards an improved and harmonized ICD-coded definition of sepsis.

No MeSH data available.


Related in: MedlinePlus