Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System

Hou, Jason K.; Tan, Mimi C.; Stidham, Ryan W.; Colozzi, John; Adams, Devon; El–Serag, Hashem B.; Waljee, Akbar K.

doi:10.1007/s10620-014-3174-7

Cited by 76 publications

(47 citation statements)

References 13 publications

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“…ICD-9-CM coding has demonstrated accuracy in IBD 47,48 and other studies of gastrointestinal disorders, 49 however this remains a concern in our population given mixed performance within studies of patients with IBD in the Veterans Affairs system. 50,51 There also exists the potential for underdiagnosis of other risk factors, particularly tobacco use and obesity. 52 …”

Section: Discussionmentioning

confidence: 99%

Hospitalizations for Acute Myocardial Infarction Are Decreased Among Patients with Inflammatory Bowel Disease Using a Nationwide Inpatient Database

Barnes

Beery

Schulman

et al. 2016

Inflammatory Bowel Diseases

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Background: Questions remain regarding the true prevalence of cardiovascular events such as myocardial infarction (MI) among patients with Inflammatory Bowel Disease (IBD). Using the Nationwide Inpatient Sample (NIS), we aimed to compare the proportion of hospitalizations for acute MI among patients with IBD to that of the general population. Methods: This study used data from years 2000–2011 in NIS, the largest publicly available all-payer inpatient database in the US. International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) discharge codes were used to identify adult patients with discharge diagnoses of IBD (Ulcerative Colitis or Crohn’s Disease), acute MI, and multiple comorbid risk factors for cardiovascular disease. The independent effect of a diagnosis of IBD on risk of acute MI was examined using a multivariable logistic regression model controlling for multiple confounders. Data were analyzed using SAS survey procedures and weighted to reflect national estimates. Results: We identified 567,438 hospitalizations among patients with IBD and 78,121,000 hospitalizations among the general population. Patients with IBD were less likely to be hospitalized for acute MI than patients in the general population (1.3% vs. 3.1%, p<0.001). In adjusted analyses, the odds of hospitalization for acute MI among patients with IBD were decreased when compared to the general population (OR 0.51, 95% CI 0.50 – 0.52). Conclusions: Despite prior reports of a potentially increased risk of acute MI among patients with IBD, in a nationwide inpatient database, lower rates of acute MI were demonstrated in the IBD population when compared to the general population.

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Section: Discussionmentioning

confidence: 99%

Hospitalizations for Acute Myocardial Infarction Are Decreased Among Patients with Inflammatory Bowel Disease Using a Nationwide Inpatient Database

Barnes

Beery

Schulman

et al. 2016

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

show abstract

“…Coding may be more complete in parts of the US health care system in which reimbursement depends on the codes assigned. Previous studies have found that diagnosis codes assigned in VA administrative data accurately represent the prevalence of some conditions (eg, post-traumatic stress disorder and diabetes) but underestimate others (eg, ulcerative colitis and chronic kidney disease) [20][21][22][23][24][25][26][27][28][29][30]. We are unaware of any study evaluating the accuracy of VA coding of the diagnoses and procedures needed to assess appropriateness of LS MRI orders.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Two Measures of Lumbar Spine MRI Overuse: Administrative Data Versus Chart Review

Avoundjian

Gidwani

Yao

et al. 2016

Journal of the American College of Radiology

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“…VA users with IBD were identified using a previously validated ICD-9 diagnosis code algorithm [7] of at least 2 VA encounters for UC or CD with at least 1 IBD-associated VA outpatient encounter from the fiscal years 1998 to 2012. The date of the first documentation of an IBD code served as the IBD index date.…”

Section: Methodsmentioning

confidence: 99%

Gastric Acid Suppression Is Associated with an Increased Risk of Adverse Outcomes in Inflammatory Bowel Disease

Shah

Richardson

et al. 2017

Digestion

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Background: The intestinal microbiota may influence inflammatory bowel disease (IBD) activity. Histamine 2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) can alter the intestinal microbiota. The aim of this study was to assess the relationship between H2RAs, PPIs, and IBD-related outcomes. Methods: We conducted a case-control study of IBD patients using the Veterans Health Affairs databases. Cases were defined by their first instance of an IBD-related hospitalization or surgery and the exposure of interest was H2RA or PPI use 30 days prior to the outcome. Incidence density ratios were calculated using conditional logistic regression. Results: In a cohort of 58,459 patients with IBD, we found 4,887 cases and 9,761 controls with ulcerative colitis (UC) and 4,876 cases and 9,745 controls with Crohn disease (CD). Filled prescriptions for H2RAs were associated with an increased risk of IBD-related hospitalization or surgery in CD patients (adjusted incidence density ratio 1.18; 95% CI 1.03-1.34). A similar association was found for PPIs in UC patients (adjusted incidence density ratio 1.11; 95% CI 1.02-1.21) and CD patients (adjusted incidence density ratio 1.12; 95% CI 1.02-1.22). Conclusions: H2RAs and PPIs were associated with a modestly increased risk of IBD-related hospitalization or surgery.

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Accuracy of Diagnostic Codes for Identifying Patients with Ulcerative Colitis and Crohn’s Disease in the Veterans Affairs Health Care System

Abstract: Single ICD-9 codes are inadequate to accurately define IBD patients; however, ICD-9 code algorithms can be used to identify patients with UC or CD with high positive predictive value. The 2 code, at least 1 outpatient code algorithm was observed to have a high PPV and low miss rate.

Cited by 76 publications

References 13 publications

Hospitalizations for Acute Myocardial Infarction Are Decreased Among Patients with Inflammatory Bowel Disease Using a Nationwide Inpatient Database

Hospitalizations for Acute Myocardial Infarction Are Decreased Among Patients with Inflammatory Bowel Disease Using a Nationwide Inpatient Database

Evaluating Two Measures of Lumbar Spine MRI Overuse: Administrative Data Versus Chart Review

Gastric Acid Suppression Is Associated with an Increased Risk of Adverse Outcomes in Inflammatory Bowel Disease

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