Cervical Intraepithelial Neoplasia Grade 3 and Adenocarcinoma In Situ: Comparison of ICD-9 Codes and Pathology Results—Kaiser Permanente, United States, 2000–2005

Abstract

Background: Cervical intraepithelial neoplasia grade 3þ (CIN3þ) and adenocarcinoma in situ incidence will be an important measure of HPV vaccine impact. Integrated healthcare delivery systems, such as Kaiser Permanente, could be used to monitor CIN3þ trends; however, limited evaluations of data from healthcare delivery systems for CIN3þ surveillance exist.Methods: We compared CIN3þ diagnoses by ICD-9 code with CIN3þ diagnoses by pathology results among 121,211 females aged 11 to 30 years who were continuously enrolled from 2000 to 2005 in either Kaiser Permanente Northern California or Kaiser Permanente Northwest. We calculated sensitivity and positive predictive value of diagnosis by ICD-9 codes using pathology CIN3þ diagnosis as the gold standard.Results: There were 1,090 women with at least one CIN3þ diagnosis by ICD-9 code 233.1 and 1,200 women with at least one CIN3þ diagnosis by pathology results. The sensitivity of the ICD-9 code for detecting a woman with at least one pathology diagnosis for CIN3þ was 62% (740/1,200); positive predictive value was 68% (740/1,090). Among women with at least one CIN3þ diagnosis by ICD-9 code, 679 (62%) had more than one visit with this code; whereas, among women with at least one CIN3þ diagnosis by pathology, 466 (39%) had more than one CIN3þ pathology result.Conclusions: ICD-9 codes may underestimate the number of women with at least one CIN3þ diagnosis. Impact: Pathology results, when available, may provide better estimates of CIN3þ incidence. Cancer Epidemiol Biomarkers Prev; 22(6); 1129-32. Ó2013 AACR.

The influence of sex and age on prevalence rates of comorbid conditions in autism

“…Third, there is currently some debate surrounding the reliability of ICD‐9 billing codes in accurately characterizing the prevalence of various disorders and diseases [Drahos, Vanwormer, Greenlee, Landgren, & Koshiol, ; Muir, ; Surie et al, ; Tanpowpong et al, ]. ICD‐9 codes do not permit distinguishing between disease and symptom‐complex.…”