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Accuracy of ICD-9-CM codes in identifying infections of pneumonia and herpes simplex virus in administrative data

2013; Elsevier BV; Volume: 23; Issue: 5 Linguagem: Inglês

10.1016/j.annepidem.2013.02.005

1873-2585

Jennifer Drahos, Jeffrey J. VanWormer, Robert T. Greenlee, Ola Landgren, Jill Koshiol,

Chronic Disease Management Strategies

Clinical epidemiology studies increasingly rely on electronic medical records data. The validity of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes is crucial as they are often used to identify conditions of interest. We evaluated the use of archived ICD-9-CM codes to identify two representative infection-related conditions, pneumonia and herpes simplex virus (HSV), in a defined health system. Records were obtained for a sample of 175 and 179 patients with ICD-9-CM codes for pneumonia and HSV, respectively. An adjudicated case status was assigned for each subject. The presence of a single ICD-9-CM code had a positive predictive value of 88% for pneumonia and 86% for HSV. False positives (noncases) accounted for less than 10% of records evaluated for each condition. Our study demonstrates that ICD-9-CM codes for pneumonia and HSV were valid markers of a true history of these conditions, suggesting that ICD-9-CM codes can be used to successfully identify infection-related conditions in epidemiologic studies. However, validation studies for individual conditions may help identify condition-specific strategies to improve the performance of diagnostic codes.