利用电子数据库进行结节病的流行病学研究越来越受欢迎。然而,结节病的诊断代码的准确性尚不清楚。
搜索了罗切斯特流行病学项目的医疗记录链接系统,以识别1995年1月1日至2013年12月31日在奥姆斯特德县的所有潜在的结节病成人病例。明尼苏达,使用国际疾病分类,第九次修订(ICD-9)代码135(结节病)。对这些潜在病例的完整医疗记录进行了单独审查。结节病的诊断通过组织病理学上的非干酪性肉芽肿的存在得到证实。胸内结节病的影像学发现,和兼容的临床表现。阳性预测值(PPV)估计为证实患有结节病的患者人数除以具有结节病诊断代码的患者人数。
研究队列包括366名至少有一个结节病代码的患者。其中,确认结节病224例,导致PPV为61.2%(95%CI56.0-66.2%)。数据库中总共268名患者至少有两次间隔至少30天的结节病代码。其中,有205例确诊的结节病。具有至少两次编码的PPV为76.5%(95%CI为71.0-81.4%)。
结节病的ICD-9代码的PPV相对较低,因此,使用电子数据库的研究需要进一步验证。
Epidemiologic
study of sarcoidosis utilizing electronic databases has been increasingly popular. However, the accuracy of diagnostic codes for sarcoidosis is unknown.
The medical record-linkage system of the Rochester Epidemiology Project was searched to identify all potential adult cases of sarcoidosis between January 1, 1995 and December 31, 2013 in Olmsted County, Minnesota, using the International Classification of Diseases, Ninth Revision (ICD-9) code 135 (sarcoidosis). Complete medical records of those potential cases were individually reviewed. The diagnosis of sarcoidosis was confirmed by the presence of non-caseating granuloma on histopathology, radiographic findings of intrathoracic sarcoidosis, and compatible clinical presentations. Positive predictive value (PPV) was estimated as the number of patients verified to have sarcoidosis divided by the number of patients with a diagnostic code for sarcoidosis.
The
study cohort included 366 patients with at least one code for sarcoidosis. Of these, 224 cases of confirmed sarcoidosis were identified, resulting in PPV of 61.2% (95% CI 56.0-66.2%). A total of 268 patients in the database had a code for sarcoidosis on least two occasions separated by at least 30 days. Of these, there were 205 cases of confirmed sarcoidosis. The PPV for having the code at least twice was 76.5% (95% CI 71.0-81.4%).
The PPV of ICD-9 code for sarcoidosis is relatively low and, thus, further verification is required for studies using electronic databases.