The accuracy of using administrative healthcare data to identify epilepsy cases: A systematic review of validation studies

Mbizvo, Gashirai K; Bennett, Kyle; Schnier, Christian; Simpson, Colin R; Duncan, Susan E.; Chin, Richard

doi:10.1111/epi.16547

Cited by 82 publications

(105 citation statements)

References 53 publications

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“…The validity of the operational definitions is another potential limitation. According to a recent systematic review, 27 administrative data can accurately identify people with epilepsy using operational definitions that combine disease codes with antiepileptic drugs (AEDs). In a previous Korean study using NHIS data, the positive predictive value for epilepsy identified using the criterion of one or more AED prescription with a diagnostic code representing epilepsy or seizure was 0.81 in 2009.…”

Section: Discussionmentioning

confidence: 99%

Increasing Trends in the Incidence and Prevalence of Epilepsy in Korea

et al. 2021

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Background and Purpose There have been few reports on recent trends in the occurrence of epilepsy. The aim of this study was to estimate the incidence and prevalence of epilepsy and analyze their annual trends in Korea over the period 2009–2017. Methods This nationwide population-based study was carried out using the National Health Insurance Service of Korea database. A prevalent case was defined as one of a patient receiving a prescription of anticonvulsants under the diagnostic codes for epilepsy or seizure. An incident case was ascertained by confirming the absence of any epilepsy-related diagnostic codes and anticonvulsant prescription for 2 years or more before the operational definition for a prevalent case was met. Alternative operational definitions for epilepsy were tested. The temporal trends of the incidence and prevalence of epilepsy were analyzed using a Poisson regression model, and are expressed as average annual percentage changes (AAPCs). Results The incidence of epilepsy increased from 28.7/100,000 persons in 2009 to 35.4/100,000 persons in 2017. The prevalence increased gradually from 3.4/1,000 persons in 2009 to 4.8/1,000 persons in 2017. These increasing trends were more evident among elderly subjects aged ≥75 years and in those who had codes for epilepsy or seizure as an additional diagnosis. Age standardization revealed a less prominent but still increasing trend in both incidence (AAPC=0.48%) and prevalence (AAPC=3.11%). Conclusions There have been increasing trends in both the prevalence and incidence of epilepsy in Korea between 2009 and 2017. This finding appears to be related to societal aging and the high incidence of symptomatic epilepsy in the elderly population.

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Section: Discussionmentioning

confidence: 99%

Increasing Trends in the Incidence and Prevalence of Epilepsy in Korea

et al. 2021

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“…We believe the best way to avoid missing data or misclassifications is a manual chart review. Previous reports showed that combinations of ICD‐10 codes and ICD‐10 codes with other medical information (i.e., medication and procedure data) improved accuracy in identifying true diagnoses 30,36 . Since Japanese administrative claims data contain not only ICD‐10 codes but also a procedure code and drug information, 18,37,38 the algorithm of the combination of the ICD‐10 codes, procedure code and drug information may increase the accuracy of claims‐based diagnosis for predicting the gold standard based on actual manual medical chart review.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Japanese claims data in identifying diabetes‐related complications

Fujihara

Yamada-Harada

Matsubayashi

et al. 2021

Pharmacoepidemiology and Drug

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Purpose To evaluate the accuracy of various claims‐based definitions of diabetes‐related complications (coronary artery disease [CAD], heart failure, cerebrovascular disease and dialysis). Methods We evaluated data on 1379 inpatients who received care at the Niigata University Medical & Dental Hospital in September 2018. Manual electronic medical chart reviews were conducted for all patients with regard to diabetes‐related complications and were used as the gold standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each claims‐based definition associated with diabetes‐related complications based on Diagnosis Procedure Combination (DPC), International Classification of Diseases, Tenth Revision (ICD‐10) codes, procedure codes and medication codes were calculated. Results DPC‐based definitions had higher sensitivity, specificity, and PPV than ICD‐10 code definitions for CAD and cerebrovascular disease, with sensitivity of 0.963–1.000 and 0.905–0.952, specificity of 1.000 and 1.000, and PPV of 1.000 and 1.000, respectively. Sensitivity, specificity, and PPV were high using procedure codes for CAD and dialysis, with sensitivity of 0.963 and 1.000, specificity of 1.000 and 1.000, and PPV of 1.000 and 1.000, respectively. DPC and/or ICD‐10 codes + medication were better for heart failure than the ICD‐10 code definition, with sensitivity of 0.933, specificity of 1.000, and PPV of 1.000. The PPVs were lower than 60% for all diabetes‐related complications using ICD‐10 codes only. Conclusion The DPC‐based definitions for CAD and cerebrovascular disease, procedure codes for CAD and dialysis, and DPC or ICD‐10 codes with medication codes for heart failure could accurately identify these diabetes‐related complications from claims databases.

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“…13 times the odds of readmission due to a psychiatric illness compared to those without epilepsy • Top psychiatric causes of readmission were mood disorders, schizophrenia and other psychotic disorders, and substance-related disorders • The results show that postpartum women with epilepsy are vulnerable to psychiatric illness requiring hospitalization International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for epilepsy (345.0, 345.1, and 345.4-345.9), excluding isolated codes for status epilepticus (345.2, 345.3) without any epilepsy codes, in any diagnostic position at or before the time of delivery. 17,18 Women who had a diagnosis of epilepsy only after delivery were excluded. Women who delivered were identified using enhanced validated ICD-9-CM obstetric delivery diagnosis and procedure codes in any position (Table S1).…”

Section: Key Pointsmentioning

confidence: 99%

Postpartum psychiatric readmissions: A nationwide study in women with and without epilepsy

et al. 2021

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Objective: To assess whether epilepsy is associated with increased odds of 30-day readmission due to psychiatric illness during the postpartum period. Methods: The 2014 Nationwide Readmissions Database and the International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify postpartum women up to 50 years old in the United States, including the subgroup with epilepsy. The primary outcome was 30-day readmission and was categorized as (1) readmission due to psychiatric illness, (2) readmission due to all other causes, or (3) no readmission. Secondary outcome was diagnosis at readmission. The association of the primary outcome and presence of epilepsy was examined using multinomial logistic regression. Results: Of 1 558 875 women with admissions for delivery identified, 6745 (.45%) had epilepsy. Thirteen of every 10 000 women had 30-day psychiatric readmissions in the epilepsy group compared to one of every 10 000 in the no-epilepsy group (p < .0001). Of every 10 000 women with epilepsy, 256 had 30-day readmissions due to other causes compared to 115 of every 10 000 women in the no-epilepsy group (p < .0001). The odds ratio for readmission due to psychiatric illness was 10.13 (95% confidence interval = 5.48-18.72) in those with epilepsy compared to those without.Top psychiatric causes for 30-day readmissions among women with epilepsy were mood disorders, schizophrenia and other psychotic disorders, and substance-related disorders. Significance: This large-scale study demonstrated that postpartum women with epilepsy have higher odds of readmission due to a psychiatric illness compared to women without epilepsy. Postpartum treatment strategies and interventions to prevent psychiatric readmissions are necessary in this vulnerable population.

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The accuracy of using administrative healthcare data to identify epilepsy cases: A systematic review of validation studies

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 82 publications

References 53 publications

Increasing Trends in the Incidence and Prevalence of Epilepsy in Korea

Increasing Trends in the Incidence and Prevalence of Epilepsy in Korea

Accuracy of Japanese claims data in identifying diabetes‐related complications

Postpartum psychiatric readmissions: A nationwide study in women with and without epilepsy

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