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Validity of ICD-based algorithms to estimate the prevalence of injection drug use among infective endocarditis hospitalizations in the absence of a reference standard
- Source :
- Drug Alcohol Depend
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background International Classification of Diseases (ICD) code algorithms are routinely used to estimate the frequency of illicit injection drug use (IDU)-associated hospitalizations in administrative health datasets despite a lack of evidence regarding their validity. We aimed to measure the sensitivity and specificity of ICD code algorithms used to estimate the prevalence of current/recent IDU among infective endocarditis (IE) hospitalizations without a reference standard. Methods We reviewed medical records of 321 patients aged 18–64 years old from an urban academic hospital with an IE diagnosis between 2007 and 2017. Diagnostic tests for IDU included self-reported IDU in medical records; a drug use, abuse and dependence (UAD) ICD algorithm; a Hepatitis C Virus (HCV) ICD algorithm; and a combination drug UAD/HCV ICD algorithm. Sensitivity, specificity and the misclassification error (ME)-adjusted IDU prevalence were estimated using Bayesian latent class models. Results The combination algorithm had the highest sensitivity and lowest specificity. Sensitivity increased for the drug UAD algorithm in the ICD-10 period compared to the ICD-9 period. The ME-adjusted current/recent IDU prevalence estimated using the drug UAD and HCV algorithms was 23 % (95 % Bayesian credible interval: 16 %, 31 %). The unadjusted prevalence estimate from the drug UAD algorithm underestimated the ME-adjusted prevalence, while the combination algorithm overestimated it. Conclusion The validity of ICD code algorithms for IDU among IE hospitalizations is imperfect and differs between ICD-9 and ICD-10. Commonly used ICD-based algorithms could lead to substantially biased prevalence estimates in IDU-associated hospitalizations when using administrative health data.
- Subjects :
- Adult
Male
Adolescent
Toxicology
Article
Injection drug use
Young Adult
03 medical and health sciences
0302 clinical medicine
International Classification of Diseases
Prevalence
medicine
Credible interval
Humans
Endocarditis
Pharmacology (medical)
030212 general & internal medicine
Substance Abuse, Intravenous
Reference standards
Retrospective Studies
Pharmacology
business.industry
Medical record
Reproducibility of Results
Bayes Theorem
Middle Aged
Reference Standards
medicine.disease
Hospitalization
Substance abuse
Psychiatry and Mental health
Cross-Sectional Studies
Infective endocarditis
Female
business
Algorithm
Algorithms
030217 neurology & neurosurgery
Combination drug
Subjects
Details
- ISSN :
- 03768716
- Volume :
- 209
- Database :
- OpenAIRE
- Journal :
- Drug and Alcohol Dependence
- Accession number :
- edsair.doi.dedup.....61e4ac235c5b39823196b37b27d7c2ba