Abstract：
BACKGROUND: Case identification strategies to conduct population-based studies have not been developed for lichen planus (LP) or lichen planopilaris (LPP).
OBJECTIVE: The aim of this study was to assess the validity of using diagnostic codes to establish both a cutaneous (non-oral) LP cohort and an LPP cohort from a large clinical database.
METHODS: A retrospective chart review was performed to determine whether patients with ICD-9 or ICD-10 codes for LP and ICD-10 codes for LPP are confirmed cases of LP and LPP. Validation samples were used to estimate the positive predictive value (PPV) of three case definitions any LP, non-oral LP, and LPP defined as: at least one code by any physician, at least two codes by any physician, and at least one code by a dermatologist.
RESULTS: Among the 199 reviewed LP charts, 166 and 123 were confirmed cases of any LP and non-oral LP, respectively. The PPVs for any LP were: 83.4% (166/199) for one code by any physician, 84.6% (77/91) for two codes by any physician, and 95.1% (97/102) for one code by a dermatologist. The PPVs for non-oral LP were: 61.8% (123/199) for one code by any physician, 70.3% (64/91) for two diagnoses by any physician, and 86.3% (88/102) for one diagnosis by a dermatologist. Of the 139 patients with at least one code for LPP, 122 were confirmed cases of LPP. The case definition for one LPP code applied by any physician had a PPV of 87.8% (122/139) to identify a true case of LPP, whereas two diagnoses by any physician had a PPV of 96.2% (76/79) and a diagnosis by a dermatologist had a PPV of 93% (107/115).
CONCLUSIONS: Diagnosis codes for LP and LPP, restricted by the diagnosing physician\'s specialty, may be used to accurately identify case cohorts of overall LP, non-oral LP, or LPP in large clinical databases.
OBJECTIVE: The aim of this study was to assess the validity of using diagnostic codes to establish both a cutaneous (non-oral) LP cohort and an LPP cohort from a large clinical database.
METHODS: A retrospective chart review was performed to determine whether patients with ICD-9 or ICD-10 codes for LP and ICD-10 codes for LPP are confirmed cases of LP and LPP. Validation samples were used to estimate the positive predictive value (PPV) of three case definitions any LP, non-oral LP, and LPP defined as: at least one code by any physician, at least two codes by any physician, and at least one code by a dermatologist.
RESULTS: Among the 199 reviewed LP charts, 166 and 123 were confirmed cases of any LP and non-oral LP, respectively. The PPVs for any LP were: 83.4% (166/199) for one code by any physician, 84.6% (77/91) for two codes by any physician, and 95.1% (97/102) for one code by a dermatologist. The PPVs for non-oral LP were: 61.8% (123/199) for one code by any physician, 70.3% (64/91) for two diagnoses by any physician, and 86.3% (88/102) for one diagnosis by a dermatologist. Of the 139 patients with at least one code for LPP, 122 were confirmed cases of LPP. The case definition for one LPP code applied by any physician had a PPV of 87.8% (122/139) to identify a true case of LPP, whereas two diagnoses by any physician had a PPV of 96.2% (76/79) and a diagnosis by a dermatologist had a PPV of 93% (107/115).
CONCLUSIONS: Diagnosis codes for LP and LPP, restricted by the diagnosing physician\'s specialty, may be used to accurately identify case cohorts of overall LP, non-oral LP, or LPP in large clinical databases.
摘要：
背景：尚未针对扁平苔藓（LP）或扁平苔藓（LPP）开发进行基于人群的研究的病例识别策略。
目的：为了评估使用诊断代码建立整体LP队列的有效性，皮肤（非口服）LP队列，和来自大型临床数据库的LPP队列。
方法：进行回顾性分析，以确定ICD-9或ICD-10编码LP和ICD-10编码LPP的患者是否为LP和LPP的确诊病例。验证样本用于估计三个病例定义的阳性预测值（PPV），任何LP，非口腔LP，和LPP定义为：至少一个代码由任何医生，至少有两个医生的密码，和至少一个皮肤科医生的密码.
结果：在经过审查的199张LP图表中，166例和123例确诊为任何LP和非口腔LP，分别。任何LP的PPV为：任何医生的一个代码的83.4％（166/199），84.6%(77/91)对于任何医生的两个代码，皮肤科医生的一个代码为95.1％（97/102）。非口腔LP的PPV为：61.8%(123/199)，任何医生的一个代码，70.3%(64/91)由任何医生进行两次诊断，皮肤科医生诊断为86.3%(88/102)。在139名至少有一个LPP代码的患者中，122例确诊为LPP。任何医生应用的一个LPP代码的病例定义具有87.8％（122/139）的PPV，以识别LPP的真实病例。而由任何医生诊断的PPV为96.2%(76/79),由皮肤科医生诊断的PPV为93%(107/115).
结论：任何医生应用的LP和LPP诊断代码可能会产生任何形式的LP和LPP的roust和特定病例队列，分别。使用由皮肤科医生应用的LP代码对于准确识别非口腔LP病例可能是必要的。
目的：为了评估使用诊断代码建立整体LP队列的有效性，皮肤（非口服）LP队列，和来自大型临床数据库的LPP队列。
方法：进行回顾性分析，以确定ICD-9或ICD-10编码LP和ICD-10编码LPP的患者是否为LP和LPP的确诊病例。验证样本用于估计三个病例定义的阳性预测值（PPV），任何LP，非口腔LP，和LPP定义为：至少一个代码由任何医生，至少有两个医生的密码，和至少一个皮肤科医生的密码.
结果：在经过审查的199张LP图表中，166例和123例确诊为任何LP和非口腔LP，分别。任何LP的PPV为：任何医生的一个代码的83.4％（166/199），84.6%(77/91)对于任何医生的两个代码，皮肤科医生的一个代码为95.1％（97/102）。非口腔LP的PPV为：61.8%(123/199)，任何医生的一个代码，70.3%(64/91)由任何医生进行两次诊断，皮肤科医生诊断为86.3%(88/102)。在139名至少有一个LPP代码的患者中，122例确诊为LPP。任何医生应用的一个LPP代码的病例定义具有87.8％（122/139）的PPV，以识别LPP的真实病例。而由任何医生诊断的PPV为96.2%(76/79),由皮肤科医生诊断的PPV为93%(107/115).
结论：任何医生应用的LP和LPP诊断代码可能会产生任何形式的LP和LPP的roust和特定病例队列，分别。使用由皮肤科医生应用的LP代码对于准确识别非口腔LP病例可能是必要的。
