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. 2021;39(3):243-246.
doi: 10.1159/000510981. Epub 2020 Aug 19.

Validity of International Classification of Diseases, Tenth Revision, Codes for Cirrhosis

Nathan S Ramrakhiani  1 , Michael H Le  1 , Yee Hui Yeo  1 , An K Le  1 , Mayumi Maeda  1 , Mindie H Nguyen  2
Affiliations

Validity of International Classification of Diseases, Tenth Revision, Codes for Cirrhosis

Nathan S Ramrakhiani et al. Dig Dis. 2021.

Abstract

Introduction: Accurate identification of patients with cirrhosis is important for research using administrative databases. We aimed to examine the accuracy of several major ICD-10 codes for cirrhosis diagnosis in a large and diverse patient cohort; there is little existing research on this topic.

Methods: Using data from 3,396 patients with chronic liver disease (hepatitis B or C or nonalcoholic fatty liver disease) from 1 university and several community medical centers, we calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value, and area under the receiver operating characteristic curve (AUROC) for several major ICD-10 codes for cirrhosis, which was verified by individual chart review. We performed a secondary validation in a general cohort of 1,560 randomly selected patients.

Results: While each of the individual study ICD-10 codes were specific (98.08-100%), none of the codes were sufficiently sensitive (0.27-55.70%). PPVs were high in the chronic liver disease cohort (88.41-100%) but lower in the general population (55.53-66.76%). The AUROC for having at least 1 code was higher (0.79) than any code alone (0.50-0.65).

Discussion/conclusion: Individual ICD-10 codes are suboptimal for identifying patients with cirrhosis in the general patient population. We recommend conditioning ICD-10 code searches with a chronic liver disease diagnosis code and/or combining diagnostic codes to maximize performance.

Keywords: International Classification of Diseases; Liver cirrhosis; Validation study.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Receiver operating characteristic curve for the presence of any ICD-10 code.
See this image and copyright information in PMC

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