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Validity of international classification of disease codes to identify ischemic stroke and intracranial hemorrhage among individuals with associated diagnosis of atrial fibrillation.
- Source :
-
Circulation. Cardiovascular quality and outcomes [Circ Cardiovasc Qual Outcomes] 2015 Jan; Vol. 8 (1), pp. 8-14. Date of Electronic Publication: 2015 Jan 13. - Publication Year :
- 2015
-
Abstract
- Background: Because of its association with death and disability, stroke is a focus of outcomes in atrial fibrillation (AF) research. International Classification of Disease-Ninth Revision (ICD-9) edition codes are commonly used to identify stroke in research, particularly in large administrative data. We sought to assess the validity of ICD-9 codes in stroke case ascertainment and for AF across 3 institutions.<br />Methods and Results: Participating centers included Boston Medical Center (safety net hospital), Geisinger Health System (rural Pennsylvania), and the University of Alabama (academic center in the southeastern stroke belt). ICD-9 codes for ischemic stroke (433-434, 436) and intracranial hemorrhage (430-432) identified 1812 stroke cases with an associated code for AF (427.31) from 2006 to 2010. Cases were vetted through chart review with final adjudication by a stroke neurologist. Review considered 94.2% of ICD-9 identified stroke cases valid with decreased accuracy for concurrent AF diagnosis (82.28%) and stroke attributable to AF (72.8%). Among events with "without infarction" modifiers, 7.2% were valid strokes. ICD-9 stroke code accuracy did not differ by stroke type or site. Stroke code 434 displayed higher accuracy than 433 (94.4% versus 85.2%; P<0.01), and primary stroke codes were more accurate than nonprimary codes (97.2% versus 83.7%; P<0.0001).<br />Conclusions: Using ICD-9 stroke and AF codes to identify patients with stroke plus AF resulted in inaccuracies. Given the expanded financial and policy implications of patient-oriented research, conclusions derived solely from administrative data without validation of outcome events should be interpreted with caution.<br /> (© 2015 American Heart Association, Inc.)
- Subjects :
- Aged
Aged, 80 and over
Atrial Fibrillation classification
Atrial Fibrillation epidemiology
Brain Ischemia classification
Brain Ischemia epidemiology
Databases, Factual
Female
Humans
Intracranial Hemorrhages classification
Intracranial Hemorrhages epidemiology
Male
Medical Records
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Stroke classification
Stroke epidemiology
United States epidemiology
Atrial Fibrillation diagnosis
Brain Ischemia diagnosis
Data Mining methods
International Classification of Diseases
Intracranial Hemorrhages diagnosis
Stroke diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7705
- Volume :
- 8
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular quality and outcomes
- Publication Type :
- Academic Journal
- Accession number :
- 25587093
- Full Text :
- https://doi.org/10.1161/CIRCOUTCOMES.113.000371