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Development and validation of case-finding algorithms to identify acute pancreatitis in the Veterans Health Administration.
Wang, Louise L; Dobkin, Jane; Salgado, Sanjay; Kaplan, David E; Yang, Yu-Xiao.
Afiliación
  • Wang LL; Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Dobkin J; Department of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Salgado S; Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Kaplan DE; Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Yang YX; Medicine Services, GI Section, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
Pharmacoepidemiol Drug Saf ; 31(12): 1294-1299, 2022 12.
Article en En | MEDLINE | ID: mdl-36222554
PURPOSE: Acute pancreatitis (AP) is a frequently encountered adverse drug reaction. However, the validity of diagnostic codes for AP is unknown. We aimed to determine the positive predictive value (PPV) of a diagnostic code-based algorithm for identifying patients with AP within the US Veterans Health Administration and evaluate the value of adding readily available structured laboratory information. METHODS: We identified patients with possible AP events first based on the presence of a single hospital discharge ICD-9 or ICD-10 diagnosis of AP (Algorithm 1). We then expanded Algorithm 1 by including relevant laboratory test results (Algorithm 2). Specifically, we considered amylase or lipase serum values obtained between 2 days before admission and the end of the hospitalization. Medical records of a random sample of patients identified by the respective algorithms were reviewed by two separate gastroenterologists to adjudicate AP events. The PPV (95% confidence interval [CI]) for the algorithms were calculated. RESULTS: Algorithm 2, consisting of one ICD-9 or ICD-10 hospital discharge diagnosis of AP and the addition of lipase serum value ≥200 U/L, had a PPV 89.1% (95% CI 83.0%-95.2%), improving from the PPV of algorithm 1 (57.9% [95% CI 46.8-69.0]). CONCLUSIONS: An algorithm consisting of an ICD-9 or ICD-10 diagnosis of AP with a lipase value ≥200 U/L achieved high PPV. This simple algorithm can be readily implemented in any electronic health records (EHR) systems and could be useful for future pharmacoepidemiologic studies on AP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreatitis / Salud de los Veteranos Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Pharmacoepidemiol Drug Saf Asunto de la revista: EPIDEMIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreatitis / Salud de los Veteranos Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Pharmacoepidemiol Drug Saf Asunto de la revista: EPIDEMIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido