Veteran's affairs hospital discharge databases coded serious bacterial infections accurately

Computerized definitions showed high positive predictive values for identifying hospitalizations for congestive heart failure and selected infections in Medicaid enrollees with rheumatoid arthritis

“…12,13 Similarly, a study that used principal discharge diagnoses from a regional Veterans Affairs system showed that computerized definitions for bacteremia had PPVs ranging from 86%-91%. 7 Our study complements these previous studies by demonstrating that computerized definitions can be used not only to identify the presence of a condition but could also identify the actual reason for hospitalization.…”

“…Since the occurrence of nosocomial events depends on factors not typically recorded in administrative databases, our goal was to identify events that resulted in hospitalization rather than nosocomial events. 7 A computer-generated random number was assigned to each hospitalization record identified and to each eligible hospital. For logistical reasons we restricted our chart review to hospitals located within a radius of 200 miles around Nashville, TN.…”

“…2 Using data from the Veterans Affairs system, a recent study reported that 70% of bacterial pneumonia hospitalizations could be confirmed through chart review. 7 Nevertheless, similar outcome information for Medicaid patients with RA is limited. In addition, it is unclear whether recorded diagnoses examined in previous studies actually represented the main reason for hospitalization or an in-hospital event.…”

The risk of infection associated with tumor necrosis factor α antagonists: Making sense of epidemiologic evidence

“…Moreover, one must rely on diagnosis and procedure codes provided by physicians and hospitals during routine encounters. Although coding algorithms for many conditions, including infections, have been developed and assessed (21), some misclassification of outcomes is inevitable. Some investigators have augmented the information from these databases by obtaining medical records, to confirm or refute specific infection diagnoses (22).…”

The need for validation of large administrative databases: Veterans Health Administration ICD-9CM coding of exudative age-related macular degeneration and ranibizumab usage

“…For instance within the VA, detection of central venous catheter insertion determined by administrative data alone had a sensitivity of less than 12% [18], but the positive predictive value of administrative data for serious infection-related hospital admission was 80% [19]. Internal vetting of VA data occurs through planned reviews, and for instance, the DSS and PBM pharmacy data have been reported to be similar.…”