Validation of ICD-10 codes for the identification of paediatric out-of-hospital cardiac arrest patients

Gray, Katelyn; Cameron, Shona; McKenzie, Kate; Miller, Michael R.; Odoardi, Natalya; Tijssen, Janice A.

doi:10.1016/j.resuscitation.2021.12.017

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…First, the algorithms were developed using data from only one hospital, just like some previous studies. 17 , 18 It is thus unclear whether the study findings can be generalized to the whole population covered by Taiwan’s NHI. However, at least, the developed algorithms performed well on the dataset from another hospital.…”

Section: Discussionmentioning

confidence: 99%

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Validation of ICD-9-CM and ICD-10-CM Diagnostic Codes for Identifying Patients with Out-of-Hospital Cardiac Arrest in a National Health Insurance Claims Database

Tsai¹,

Tsai²,

Pan³

et al. 2022

CLEP

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Purpose Taiwan’s national health insurance (NHI) database is a valuable resource for large-scale epidemiological and long-term survival research for out-of-hospital cardiac arrest (OHCA). We developed and validated case definition algorithms for OHCA based on the International Classification of Diseases (ICD) diagnostic codes and billing codes for NHI reimbursement. Patients and Methods Claims data and medical records of all emergency department visits from 2010 to 2020 were retrieved from the hospital’s research-based database. Death-related diagnostic codes and keywords were used to identify potential OHCA cases, which were ascertained by chart reviews. We tested the performance of the developed OHCA algorithms and validated them on an external dataset. Results The algorithm defining OHCA as any cardiac arrest (CA)-related ICD code in the first three diagnosis fields performed the best with a sensitivity of 89.5% (95% confidence interval [CI], 88.2–90.7%), a positive predictive value (PPV) of 90.6% (95% CI, 89.4–91.8%), and a kappa value of 0.900 (95% CI, 0.891–0.909). The second-best algorithm consists of any CA-related ICD code in any diagnosis field with a billing code for triage acuity level 1, achieving a sensitivity of 85.6% (95% CI, 84.1–87.0%), a PPV of 93.6% (95% CI, 92.5–94.5), and a kappa value of 0.894 (95% CI, 0.884–0.903). Both algorithms performed well in external validation. In subgroup analyses, the former algorithm performed the best in adult patients, outpatient claims, and during the ICD-9 era. The latter algorithm performed the best in the inpatient claims and during the ICD-10 era. The best algorithm for identifying pediatric OHCAs was any CA-related ICD code in the first three diagnosis fields with a billing code for triage acuity level 1. Conclusion Our results may serve as a reference for future OHCA studies using the Taiwan NHI database.

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Section: Discussionmentioning

confidence: 99%

“…A sensitivity and PPV of 87.3% and 81.4% were reported for identifying pediatric OHCA in Canadian administrative data. 18 Nevertheless, validation studies on OHCA case definitions using ICD codes are scarce in other countries. 19 …”

Section: Discussionmentioning

confidence: 99%

Validation of ICD-9-CM and ICD-10-CM Diagnostic Codes for Identifying Patients with Out-of-Hospital Cardiac Arrest in a National Health Insurance Claims Database

Tsai¹,

Tsai²,

Pan³

et al. 2022

CLEP

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“… 22 , 23 , 24 We were unable to identify any ICD algorithm validation studies for FBAO, however, this approach has been performed in cardiac arrest research. 25 , 26 , 27 Coppler et al evaluated a single algorithm of ICD-9 codes and found a remarkably poor sensitivity of 4%. They noted that their gold standard registry had better outcomes than the cases that the ICD algorithm identified, and when only considering cases with an improved outcome, the ICD algorithm had a worse sensitivity (100% for those who never achieved return of spontaneous circulation versus 19% for those who survived to ED disposition).…”

Section: Discussionmentioning

confidence: 99%

Validation of ICD-10 codes for studying foreign body airway obstructions: A health administrative data cohort study

Dunne,

Cirone,

McRae

et al. 2023

Resuscitation Plus

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“…Cases were identified using a validated algorithm described by Gray et al. 30 We included children (aged 1 day to 17 years) who experienced an OHCA and were transported to an emergency department in Ontario, Canada, between April 1, 2004, and March 31, 2020. Case ascertainment was based on International Classification of Diseases , Tenth Revision ( ICD‐10 ) codes.…”

Section: Methodsmentioning

confidence: 99%

Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

Idrees,

Anderson,

Choi

et al. 2024

JAHA

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Background Pediatric out‐of‐hospital cardiac arrest (POHCA) is associated with significant mortality and poor neurological outcomes. We aimed to describe the association between sociodemographic factors and POHCA risk in Ontario, Canada. Methods and Results We conducted a province‐wide case‐control study at ICES, where patient records are linked across administrative databases. The case group included children (1 day to 17 years of age) who experienced an OHCA between 2004 and 2020. Controls were matched up to 1:4 on age, sex, index date, and key comorbidities. We used conditional logistic regression to measure the association between sociodemographic indicators and POHCA risk. The case and control groups included 1,826 and 7,254 children, respectively. Children living in areas with the highest levels of material deprivation (adjusted odds ratio [aOR]: 2.35, 95% CI: 1.94, 2.85) and dependency (aOR: 1.22, 95% CI: 1.01, 1.48) had a higher odds of POHCA, relative to children living in regions with the lowest levels of material deprivation and dependency, respectively. Children living in neighborhoods with the lowest levels of ethnic diversity had a higher odds of POHCA (aOR: 1.62, 95% CI: 1.30, 2.01), relative to children living in neighborhoods with the highest levels of ethnic diversity. The odds of POHCA were lower in immigrants (aOR: 0.67, 95% CI: 0.47, 0.95), relative to the general population. Northern urban residence (aOR: 1.45, 95% CI: 1.13, 1.87) was associated with a higher odds of POHCA, relative to southern urban residence. Conclusions Children living in neighborhoods with high levels of marginalization may have an elevated risk of experiencing POHCA. These findings highlight the importance of addressing disparities through targeted prevention and intervention efforts.

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Validation of ICD-10 codes for the identification of paediatric out-of-hospital cardiac arrest patients

Cited by 6 publications

References 17 publications

Validation of ICD-9-CM and ICD-10-CM Diagnostic Codes for Identifying Patients with Out-of-Hospital Cardiac Arrest in a National Health Insurance Claims Database

Validation of ICD-9-CM and ICD-10-CM Diagnostic Codes for Identifying Patients with Out-of-Hospital Cardiac Arrest in a National Health Insurance Claims Database

Validation of ICD-10 codes for studying foreign body airway obstructions: A health administrative data cohort study

Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

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