Precision of tuberculosis diagnosis codes in the Central Denmark Region.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Danish medical journal Pub Date : 2025-06-12 DOI:10.61409/A12240847

Victor Næstholt Dahl, Pernille Grand Moestrup, Anders Koch, Dorte Bek Folkvardsen, Frauke Rudolf, Tina Nørregaard Gissel, Andreas Fløe

{"title":"Precision of tuberculosis diagnosis codes in the Central Denmark Region.","authors":"Victor Næstholt Dahl, Pernille Grand Moestrup, Anders Koch, Dorte Bek Folkvardsen, Frauke Rudolf, Tina Nørregaard Gissel, Andreas Fløe","doi":"10.61409/A12240847","DOIUrl":null,"url":null,"abstract":"Introduction: Correct use of tuberculosis (TB) diagnosis codes is essential for patient care, surveillance and resource allocation. We aimed to assess the positive predictive value (PPV) of TB diagnosis codes.Methods: In this retrospective cohort study, we identified patients with International Classification of Diseases, tenth version (ICD-10) TB diagnosis codes from 1 July 2020 to 30 June 2023, at two TB centres in the Central Denmark Region. Confirmed TB was defined as microbiologically confirmed TB, prescription of ≥ 3 first- or second-line TB drugs, or TB notification. All patients who did not meet these criteria and those who received fewer than three TB drugs or lacked TB notification underwent manual hospital record review to verify or exclude the TB diagnosis. PPVs were calculated as the proportion of confirmed TB diagnoses among all patients with a TB diagnosis code.Results: In total, 185/230 patients were confirmed to have TB, yielding a PPV of 80% (95% CI: 75; 85). The PPVs for TB microbiology, TB prescriptions and TB notification exceeded 95% individually. Excluding TB lupus codes increased the PPV to 89% (95% CI: 84; 93). Patients with more than one different type of TB diagnosis code had a PPV of 100% (95% CI: 93; 100). Additionally, PPVs were high when TB diagnosis codes appeared on multiple occasions, increasing with the number of occurrences (≥ 2: 85%, ≥ 3: 89%, ≥ 4: 93%).Conclusion: TB ICD-10 diagnosis codes demonstrate a moderately high PPV in Denmark, particularly when excluding TB lupus codes, highlighting the importance and complexities of diagnostic coding.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 7","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Danish medical journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.61409/A12240847","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Correct use of tuberculosis (TB) diagnosis codes is essential for patient care, surveillance and resource allocation. We aimed to assess the positive predictive value (PPV) of TB diagnosis codes.

Methods: In this retrospective cohort study, we identified patients with International Classification of Diseases, tenth version (ICD-10) TB diagnosis codes from 1 July 2020 to 30 June 2023, at two TB centres in the Central Denmark Region. Confirmed TB was defined as microbiologically confirmed TB, prescription of ≥ 3 first- or second-line TB drugs, or TB notification. All patients who did not meet these criteria and those who received fewer than three TB drugs or lacked TB notification underwent manual hospital record review to verify or exclude the TB diagnosis. PPVs were calculated as the proportion of confirmed TB diagnoses among all patients with a TB diagnosis code.

Results: In total, 185/230 patients were confirmed to have TB, yielding a PPV of 80% (95% CI: 75; 85). The PPVs for TB microbiology, TB prescriptions and TB notification exceeded 95% individually. Excluding TB lupus codes increased the PPV to 89% (95% CI: 84; 93). Patients with more than one different type of TB diagnosis code had a PPV of 100% (95% CI: 93; 100). Additionally, PPVs were high when TB diagnosis codes appeared on multiple occasions, increasing with the number of occurrences (≥ 2: 85%, ≥ 3: 89%, ≥ 4: 93%).

Conclusion: TB ICD-10 diagnosis codes demonstrate a moderately high PPV in Denmark, particularly when excluding TB lupus codes, highlighting the importance and complexities of diagnostic coding.

Funding: None.

Trial registration: Not relevant.

查看原文本刊更多论文

丹麦中部地区结核病诊断代码的准确性。

正确使用结核病诊断代码对患者护理、监测和资源分配至关重要。我们的目的是评估结核诊断代码的阳性预测值（PPV）。方法：在这项回顾性队列研究中，我们从2020年7月1日至2023年6月30日在丹麦中部地区的两个结核病中心确定了患有国际疾病分类第十版（ICD-10）结核病诊断代码的患者。确诊结核病定义为微生物确诊结核病、处方≥3种一线或二线结核病药物或结核病通报。所有不符合这些标准的患者以及接受少于三种结核药物或缺乏结核通报的患者均接受了手工医院记录审查，以核实或排除结核诊断。ppv计算为结核诊断代码的所有患者中确诊结核诊断的比例。结果：总共有185/230例患者被确诊为结核病，PPV为80% (95% CI: 75；85)。结核微生物学、结核处方和结核通报的ppv均超过95%。排除结核性狼疮代码将PPV增加到89% (95% CI: 84；93)。具有一种以上不同类型结核诊断代码的患者PPV为100% (95% CI: 93；100)。此外，当结核诊断代码多次出现时，PPVs较高，并随着出现次数的增加而增加（≥2:85%,≥3:89%,≥4:93%）。结论：结核病ICD-10诊断代码在丹麦显示出中等高的PPV，特别是在排除结核狼疮代码时，突出了诊断编码的重要性和复杂性。资金:没有。试验注册：不相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Danish medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.