Clinical Epidemiology (Apr 2024)
Validity of Major Osteoporotic Fracture Diagnoses in the Danish National Patient Registry
Abstract
Anne Clausen,1,2 Sören Möller,1,2 Michael Kriegbaum Skjødt,1,3,4 Rasmus Bank Lynggaard,5 Pernille Just Vinholt,5,6 Martin Lindberg-Larsen,7 Jens Søndergaard,8 Bo Abrahamsen,1,4 Katrine Hass Rubin1,2 1Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 2OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; 3Department of Medicine, Herlev Hospital, Copenhagen, Denmark; 4Department of Medicine, Holbæk Hospital, Holbæk, Denmark; 5Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark; 6Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 7Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; 8The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, DenmarkCorrespondence: Katrine Hass Rubin, Tel +45 21261966, Email [email protected]: To evaluate the validity of diagnosis codes for Major Osteoporotic Fracture (MOF) in the Danish National Patient Registry (NPR) and secondly to evaluate whether the fracture was incident/acute using register-based definitions including date criteria and procedural codes.Methods: We identified a random sample of 2400 records with a diagnosis code for a MOF in the NPR with dates in the year of 2018. Diagnoses were coded with the 10th revision of the International Classification of Diseases (ICD-10). The sample included 2375 unique fracture patients from the Region of Southern Denmark. Medical records were retrieved for the study population and reviewed by an algorithmic search function and medical doctors to verify the MOF diagnoses. Register-based definitions of incident/acute MOF was evaluated in NPR data by applying date criteria and procedural codes.Results: The PPV for MOF diagnoses overall was 0.99 (95% CI: 0.98;0.99) and PPV=0.99 for the four individual fracture sites, respectively. Further, analyses of incident/acute fractures applying date criteria, procedural codes and using patients’ first contact in the NPR resulted in PPV=0.88 (95% CI: 0.84;0.91) for hip fractures, PPV=0.78 (95% CI: 0.74;0.83) for humerus fractures, PPV=0.78 (95% CI: 0.73;0.83) for clinical vertebral fractures and PPV=0.87 (95% CI: 0.83;0.90) for wrist fractures.Conclusion: ICD-10 coded MOF diagnoses are valid in the NPR. Furthermore, a set of register-based criteria can be applied to qualify if the MOF fracture was incident/acute. Thus, the NPR is a valuable and reliable data source for epidemiological research on osteoporotic fractures.Keywords: major osteoporotic fractures, validity, positive predictive value, the Danish National Patient Register, algorithmic search function, epidemiology
