ArticleBMC public health2011
Accuracy of syndrome definitions based on diagnoses in physician claims.
Article in BMC public health, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of climate change on airborne and droplet-borne diseases and hospital response measures.Frontiers in public health · 2026Pooled it
- Multisystem Inflammatory Syndrome in Adults: Case Finding Through Systematic Review of Electronic Medical Records.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- Article
- A Multicenter Retrospective Cohort Study to Characterize Patients Hospitalized With Multisystem Inflammatory Syndrome in Adults and Coronavirus Disease 2019 in the United States, 2020-2021.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Development and validation of an automated emergency department-based syndromic surveillance system to enhance public health surveillance in Yukon: a lower-resourced and remote setting.BMC public health · 2021Article
- Consultations for gastroenteritis in general practice and out-of-hours services in Norway 2006-15.Family practice · 2019Article
- Validation of Diagnostic Groups Based on Health Care Utilization Data Should Adjust for Sampling Strategy.Medical care · 2017Article
- How well do ICD-9 physician claim diagnostic codes identify confirmed pertussis cases in Alberta, Canada? A Canadian Immunization Research Network (CIRN) Study.BMC health services research · 2017Article
- Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.Epidemiology and infection · 2014Article
- Emergency Medical Text Classifier: New system improves processing and classification of triage notes.Online journal of public health informatics · 2014Article
- Diagnosis of influenza: only a problem of coding?Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2014Article
- Patient, physician, encounter, and billing characteristics predict the accuracy of syndromic surveillance case definitions.BMC public health · 2012Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundCommunity clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics.
methodsWe selected a random sample of 3,600 community-based primary care physicians who practiced in the fee-for-service system in the province of Quebec, Canada in 2005-2007. We randomly selected 10 visits per physician from their claims, stratifying on syndrome type and presence, diagnosis, and month. Double-blinded chart reviews were conducted by telephone with consenting physicians to obtain information on patient diagnoses for each sampled visit. The sensitivity, specificity, and positive predictive value (PPV) of physician claims were estimated by comparison to chart review.
results1,098 (30.5%) physicians completed the chart review. A chart entry on the date of the corresponding claim was found for 10,529 (95.9%) visits. The sensitivity of syndrome definitions based on diagnostic codes in physician claims was low, ranging from 0.11 (fever) to 0.44 (respiratory), the specificity was high, and the PPV was moderate to high, ranging from 0.59 (fever) to 0.85 (respiratory). We found that rarely used diagnostic codes had a higher probability of being false-positives, and that more commonly used diagnostic codes had a higher PPV.
conclusionsFuture research should identify physician, patient, and encounter characteristics associated with the accuracy of diagnostic codes in physician claims. This would enable public health to improve syndromic surveillance, either by focusing on physician claims whose diagnostic code is more likely to be accurate, or by using all physician claims and weighing each according to the likelihood that its diagnostic code is accurate.
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