Jakob Manthey, Carolin Kilian, Ludwig Kraus, Ingo Schäfer, Anna Schranz, Bernd Schulte
{"title":"在电子健康记录中确定酒精使用障碍的严重程度。","authors":"Jakob Manthey, Carolin Kilian, Ludwig Kraus, Ingo Schäfer, Anna Schranz, Bernd Schulte","doi":"10.1186/s13011-025-00670-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) is conceptualized as a dimensional phenomenon in the DSM-5, but electronic health records (EHRs) rely on binary AUD definitions according to the ICD-10. The present study classifies AUD severity levels using EHR data and tests whether increasing AUD severity levels are linked with increased comorbidity.</p><p><strong>Methods: </strong>Billing data from two German statutory health insurance companies in Hamburg included n = 21,954 adults diagnosed with alcohol-specific conditions between 2017 and 2021. Based on ICD-10 alcohol-specific diagnoses, patients were classified into five AUD severity levels: 1 (F10.0, T51.0 or T51.9); 2 (F10.1); 3 (F10.2); 4 (F10.3/4); 5 (K70 + or one of the following diagnoses: K70.0-4, K70.9, K85.2, K85.20, K86.0, 10.5-9, E24.4, G31.2, G62.1, G72.1, I42.6, K29.2). Generalized estimating equation regression models for count data (Poisson distribution) were used to assess associations with the Elixhauser Comorbidity Score (ECS).</p><p><strong>Results: </strong>Across the study period, the annual prevalence of any AUD diagnosis varied between 2.7% and 2.9%. A dose-response relationship was observed between AUD severity and ECS, indicating that individuals with higher AUD severity experience more comorbid conditions, particularly cardiovascular and liver diseases.</p><p><strong>Conclusions: </strong>The proposal to define AUD severity levels based on ICD-10 diagnoses allows for a more nuanced analysis of AUD in EHR data.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"36"},"PeriodicalIF":3.0000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418604/pdf/","citationCount":"0","resultStr":"{\"title\":\"Identifying levels of alcohol use disorder severity in electronic health records.\",\"authors\":\"Jakob Manthey, Carolin Kilian, Ludwig Kraus, Ingo Schäfer, Anna Schranz, Bernd Schulte\",\"doi\":\"10.1186/s13011-025-00670-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Alcohol use disorder (AUD) is conceptualized as a dimensional phenomenon in the DSM-5, but electronic health records (EHRs) rely on binary AUD definitions according to the ICD-10. The present study classifies AUD severity levels using EHR data and tests whether increasing AUD severity levels are linked with increased comorbidity.</p><p><strong>Methods: </strong>Billing data from two German statutory health insurance companies in Hamburg included n = 21,954 adults diagnosed with alcohol-specific conditions between 2017 and 2021. Based on ICD-10 alcohol-specific diagnoses, patients were classified into five AUD severity levels: 1 (F10.0, T51.0 or T51.9); 2 (F10.1); 3 (F10.2); 4 (F10.3/4); 5 (K70 + or one of the following diagnoses: K70.0-4, K70.9, K85.2, K85.20, K86.0, 10.5-9, E24.4, G31.2, G62.1, G72.1, I42.6, K29.2). Generalized estimating equation regression models for count data (Poisson distribution) were used to assess associations with the Elixhauser Comorbidity Score (ECS).</p><p><strong>Results: </strong>Across the study period, the annual prevalence of any AUD diagnosis varied between 2.7% and 2.9%. A dose-response relationship was observed between AUD severity and ECS, indicating that individuals with higher AUD severity experience more comorbid conditions, particularly cardiovascular and liver diseases.</p><p><strong>Conclusions: </strong>The proposal to define AUD severity levels based on ICD-10 diagnoses allows for a more nuanced analysis of AUD in EHR data.</p>\",\"PeriodicalId\":22041,\"journal\":{\"name\":\"Substance Abuse Treatment, Prevention, and Policy\",\"volume\":\"20 1\",\"pages\":\"36\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418604/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Substance Abuse Treatment, Prevention, and Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13011-025-00670-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SUBSTANCE ABUSE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Substance Abuse Treatment, Prevention, and Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13011-025-00670-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
Identifying levels of alcohol use disorder severity in electronic health records.
Background: Alcohol use disorder (AUD) is conceptualized as a dimensional phenomenon in the DSM-5, but electronic health records (EHRs) rely on binary AUD definitions according to the ICD-10. The present study classifies AUD severity levels using EHR data and tests whether increasing AUD severity levels are linked with increased comorbidity.
Methods: Billing data from two German statutory health insurance companies in Hamburg included n = 21,954 adults diagnosed with alcohol-specific conditions between 2017 and 2021. Based on ICD-10 alcohol-specific diagnoses, patients were classified into five AUD severity levels: 1 (F10.0, T51.0 or T51.9); 2 (F10.1); 3 (F10.2); 4 (F10.3/4); 5 (K70 + or one of the following diagnoses: K70.0-4, K70.9, K85.2, K85.20, K86.0, 10.5-9, E24.4, G31.2, G62.1, G72.1, I42.6, K29.2). Generalized estimating equation regression models for count data (Poisson distribution) were used to assess associations with the Elixhauser Comorbidity Score (ECS).
Results: Across the study period, the annual prevalence of any AUD diagnosis varied between 2.7% and 2.9%. A dose-response relationship was observed between AUD severity and ECS, indicating that individuals with higher AUD severity experience more comorbid conditions, particularly cardiovascular and liver diseases.
Conclusions: The proposal to define AUD severity levels based on ICD-10 diagnoses allows for a more nuanced analysis of AUD in EHR data.
期刊介绍：
Substance Abuse Treatment, Prevention, and Policy is an open access, peer-reviewed journal that encompasses research concerning substance abuse, with a focus on policy issues. The journal aims to provide an environment for the exchange of ideas, new research, consensus papers, and critical reviews, to bridge the established fields that share a mutual goal of reducing the harms from substance use. These fields include: legislation pertaining to substance use; correctional supervision of people with substance use disorder; medical treatment and screening; mental health services; research; and evaluation of substance use disorder programs.
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