Evidence map›Paper›PMID 28701222›Full record

ArticleBMC health services research2017

How well do ICD-9 physician claim diagnostic codes identify confirmed pertussis cases in Alberta, Canada? A Canadian Immunization Research Network (CIRN) Study.

Sumana Fathima, Kimberley A Simmonds, Steven J Drews, Lawrence W Svenson, Jeffrey C Kwong, Salaheddin M Mahmud, Susan Quach, Caitlin Johnson, Kevin L Schwartz, Natasha S Crowcroft and 2 more

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In one paragraph

Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sumana FathimaCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Kimberley A SimmondsCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Steven J DrewsProvincial Laboratory (ProvLab) for Public Health, Edmonton, Alberta, Canada.
Lawrence W SvensonCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Jeffrey C KwongUniversity of Toronto, Toronto, Canada.
Salaheddin M MahmudVaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada.
Susan QuachPublic Health Ontario, Toronto, Canada.
Caitlin JohnsonPublic Health Ontario, Toronto, Canada.
Kevin L SchwartzThe Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Natasha S CrowcroftUniversity of Toronto, Toronto, Canada.
Margaret L RussellCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. mlrussel@ucalgary.ca.
Canadian Immunization Research Network (CIRN) Provincial Collaborative Network Vaccine Effectiveness Working Group

Funding

CIHR 137470
6 · The paper itself

Abstract

backgroundRates of Bordetella pertussis have been increasing in Alberta, Canada despite vaccination programs. Waning immunity from existing acellular component vaccines may be contributing to this. Vaccine effectiveness can be estimated using a variety of data sources including diagnostic codes from physician billing claims, public health records, reportable disease and laboratory databases. We sought to determine if diagnostic codes from billing claims (administrative data) are adequately sensitive and specific to identify pertussis cases among patients who had undergone disease-specific laboratory testing.

methodsData were extracted for 2004-2014 from a public health communicable disease database that contained data on patients under investigation for B. pertussis (both those who had laboratory tests and those who were epidemiologically linked to laboratory-confirmed cases) in Alberta, Canada. These were deterministically linked using a unique lifetime person identifier to the provincial billing claims database, which contains International Classification of Disease version 9 (ICD-9) diagnostic codes for physician visits. We examined visits within 90 days of laboratory testing. ICD-9 codes 033 (whooping cough), 033.0 (Bordetella pertussis), 033.1 (B. parapertussis), 033.8 (whooping cough, other specified organism), and 033.9 (whooping cough, other unspecified organism) in any of the three diagnostic fields for a claim were classified as being pertussis-specific codes. We calculated sensitivity, specificity, positive (PPV) and negative (NPV) predictive values.

resultsWe identified 22,883 unique patients under investigation for B. pertussis. Of these, 22,095 underwent laboratory testing. Among those who had a laboratory test, 2360 tested positive for pertussis. The sensitivity of a pertussis-specific ICD-9 code for identifying a laboratory-confirmed case was 38.6%, specificity was 76.9%, PPV was 16.0%, and NPV was 91.6%.

conclusionICD-9 codes from physician billing claims data have low sensitivity and moderate specificity to identify laboratory-confirmed pertussis among persons tested for pertussis.

Indexed as

Insurance Claim ReportingInternational Classification of DiseasesPhysiciansAlbertaBiomedical ResearchDatabases, FactualFemaleHumansInfantMaleWhooping CoughHealth services researchICD 9International classification of diseasesPertussisSensitivitySpecificityValidation studies

Identifiers

PMID28701222
PMCPMC5508611

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.