Case Definitions for Chronic Rhinosinusitis in Administrative Data: A Systematic Review

Abstract

To optimize the accuracy of pharmacoepidemiologic research for CRS that used administrative data, it is important to apply appropriate case definitions for CRS. Various nonvalidated CRS case definitions are currently being used in administrative data base research. There is a need to develop a generalizable and validated ICD-based CRS case definition to increase the accuracy of future pharmacoepidemiologic research.

How Often is Sinus Surgery Performed for Chronic Rhinosinusitis with versus without Nasal Polyps?

“…There were limitations with using CPT codes to identify cases and with ICD-9 codes to determine diagnosis because it was not possible to know the exact indications for surgery because they are not explicitly linked in the data set. 37 The data set also does not provide any information regarding the burden of disease, such as the 22-item Sino-Nasal Outcome Test scores or the Lund-Mackay scores. As with all studies that used administrative data bases, this study was dependent on the accuracy of the coding of the surgical procedure.…”

Observational retrospective study calculating health service costs of patients receiving surgery for chronic rhinosinusitis in England, using linked patient-level primary and secondary care electronic data

“…15 16 The population used was a subset of the cohort used in previous work by this group that considered the risk of mortality and cardiovascular events following macrolide prescription in patients with CRS. 17 An EHR phenotyping algorithm, comprising primary care and secondary care diagnoses and secondary care procedures deemed to indicate a 'definite' diagnosis of CRS, was developed in collaboration with clinicians (see online supplemental material, section A) using a similar approach to that published by Rudmik et al, Lui and Rudmik, and Macdonald et al [18][19][20] Patients with one or more of these diagnoses or procedures recorded were classified as 'definite' CRS cases, with the date of diagnosis taken as the date of the first such specified diagnosis or procedure. A further list of 'definite' and 'very likely' surgery OPCS Classification of Interventions and Procedures version 4 (OPCS-4) codes was similarly developed, and the surgical cohort used in this cost analysis was the group of patients with 'definite' CRS who had had surgery defined as either 'definitely' or 'very likely' to have been for CRS (see online supplemental material, section A).…”

A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective

“…Two recent systematic reviews demonstrated that current administrative database studies failed to consider the accuracy of their CRS cohort and applied 8 different case definitions. Furthermore, the only validated case definition for CRS incorporated a U.S.–specific common procedural terminology (CPT) code, thus limiting the generalizability to other countries …”