A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2024-11-01 DOI:10.1002/pds.70024

Lamia Y Haque, Janet P Tate, Michael Chew, Ellen C Caniglia, Tamar H Taddei, Vincent Lo Re

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引用次数: 0

Abstract

Purpose: Accurate identification of hepatic decompensation is essential for pharmacoepidemiologic research among patients with chronic liver disease.

Methods: An algorithm using ≥ 1 inpatient or ≥ 2 outpatient International Classification of Diseases, 10th revision (ICD-10) codes for hepatic decompensation was developed in Veterans Health Administration data from October 2015 through July 2019. Medical records were reviewed by hepatologists to confirm cases. The positive predictive value (PPV) of the coding algorithm for confirmed hepatic decompensation was calculated.

Results: Hepatic decompensation was confirmed in 149/185 records meeting the algorithm (PPV 81%; 95% CI, 70%, 90%). The most common hepatic decompensation diagnosis was ascites. Only 56% of confirmed cases had an accompanying diagnosis code for cirrhosis.

Conclusions: Our ICD-10-based coding algorithm identified hepatic decompensation with high PPV in Veterans Health Administration data.

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退伍军人健康管理局电子病历系统中识别肝功能衰竭的验证算法。

目的：准确识别肝功能失代偿对慢性肝病患者的药物流行病学研究至关重要：在退伍军人健康管理局 2015 年 10 月至 2019 年 7 月的数据中，使用≥ 1 个住院病人或≥ 2 个门诊病人的《国际疾病分类》第 10 次修订版（ICD-10）代码制定了肝功能失代偿的算法。肝病专家对病历进行了审查，以确认病例。计算了确诊肝功能失代偿编码算法的阳性预测值（PPV）：符合该算法的 149/185 份病历确认了肝功能失代偿（PPV 为 81%；95% CI 为 70%，90%）。最常见的肝功能失代偿诊断是腹水。只有 56% 的确诊病例伴有肝硬化诊断代码：我们基于 ICD-10 的编码算法在退伍军人健康管理局的数据中识别出了肝功能失代偿，其 PPV 很高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.