Clinical Epidemiology (Jan 2022)
Positive Predictive Value of ICD-10 Codes for Cerebral Venous Sinus Thrombosis in Taiwan’s National Health Insurance Claims Database
Abstract
Shu-Chen Liao,1,2 Shih-Chieh Shao,3,4 Edward Chia-Cheng Lai,4 Swu-Jane Lin,5 Wei-I Huang,6 Cheng-Yang Hsieh4,7 1Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; 2Chang Gung University College of Medicine, Taoyuan, Taiwan; 3Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; 4School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA; 6Taiwan Drug Relief Foundation, Taipei, Taiwan; 7Department of Neurology, Tainan Sin Lau Hospital, Tainan, TaiwanCorrespondence: Cheng-Yang HsiehDepartment of Neurology, Tainan Sin Lau Hospital, 57, Section 1, Dongmen Road, East District, Tainan, 70142, TaiwanTel +886-6-274-8316, ext. 4180Fax +886-6-282-4178Email [email protected]: This study aims to determine the positive predictive value (PPV) of case definitions for cerebral venous sinus thrombosis (CVST) in Taiwan’s National Health Insurance claims database based on the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnostic codes.Study Design and Setting: Inpatient records with ICD-10-CM codes of G08, I629, I636, or I676 were retrieved from the claims data of all hospital branches of Chang Gung Medical Foundation. Manual review of the medical records and images was performed in order to ascertain the diagnosis. The PPV of various case definitions for CVST was estimated.Results: Of the 380 hospitalizations, 166 and 214 were determined to be true-positive and false-positive episodes of acute CVST, respectively. The PPV of the ICD-10-CM codes of G08, I629, I636, and I676 was 88.2%, 2.0%, 100.0%, and 91.3%, respectively. The PPV generally increased when acute CVST was defined as a primary diagnosis or as ICD-10-CM codes plus anticoagulant use. Miscoding in other conditions, tentative diagnosis, and remote episode of CVST were determined as the main reasons for false-positive diagnosis of acute CVST.Conclusion: This study determined the PPV of ICD-10-CM codes for identifying CVST, which may offer a reference for future claims-based research.Keywords: hospitalization claims data, positive predictive value, diagnostic codes, ICD-10-CM, cerebral venous sinus thrombosis, Taiwan
