ArticleBMC medical research methodology2019
Sensitivity and specificity of an algorithm based on medico-administrative data to identify hospitalized patients with major bleeding presenting to an emergency department.
Article in BMC medical research methodology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Clinically Relevant Bleeding in Individuals With Cancer: Insights From a Nationwide Cohort Study.American journal of hematology · 2026Article
- Drug-Drug Interaction Signals for Major Bleeding in Nursing Home Residents: High-Throughput Screening of Clopidogrel and Oral Anticoagulants.Pharmacoepidemiology and drug safety · 2026Article
- Validation of electronic health record-based International Society on Thrombosis and Haemostasis bleeding algorithms in a US health system.Research and practice in thrombosis and haemostasis · 2026Article
- Differences in bleeding outcome capture between electronic health record review using natural language processing and ICD-10 coding in hospitalised children.Pediatric research · 2026Article
- Low-Dose Aspirin for Cardiovascular Disease Primary Prevention in Patients With Giant Cell Arteritis.JAMA network open · 2026Article
- ICD-10 code validation for gastrointestinal bleeding in patients receiving oral anticoagulation: nationwide cohort study.BMC gastroenterology · 2025Article
- Burden of status epilepticus: prognosis and cost driving factors, insight from a nationwide retrospective cohort study of the French health insurance database.Journal of neurology · 2024Article
- COVID-19 pandemic and trends in clinical outcomes and medication use for patients with established atrial fibrillation: A nationwide analysis of claims data.American heart journal plus : cardiology research and practice · 2024Article
- Risk of Major Bleeding Associated with Concomitant Direct-Acting Oral Anticoagulant and Clopidogrel Use: A Retrospective Cohort Study.Drug safety · 2024Article
- In hospitalized patients undergoing therapeutic plasma exchange, major bleeding prevalence depends on the bleeding definition: An analysis of The Recipient Epidemiology and Donor Evaluation Study-III.Journal of clinical apheresis · 2023Article
- Initiation of oral anticoagulation in US older adults newly diagnosed with atrial fibrillation during hospitalization.Journal of the American Geriatrics Society · 2023Article
- Association between Early Venous Thromboembolism Prophylaxis, Bleeding Risk, and Venous Thromboembolism among Critically Ill Patients with Thrombocytopenia.Annals of the American Thoracic Society · 2023Article
- Atrial fibrillation as a novel risk factor for retinal stroke: A protocol for a population-based retrospective cohort study.PloS one · 2023Article
- Review Article: Gastrointestinal Bleeding Risk with Direct Oral Anticoagulants.Cardiovascular drugs and therapy · 2022Review
- Clinical use of low-dose parenteral anticoagulation, incidence of major bleeding and mortality: a multi-centre cohort study using the French national health data system.European journal of clinical pharmacology · 2022Article
- Red Blood Cell Transfusion at a Hemoglobin Threshold of 7 g/dl in Critically Ill Patients: A Regression Discontinuity Study.Annals of the American Thoracic Society · 2022Article
- Article
- Major bleeding risk associated with oral anticoagulant in real clinical practice. A multicentre 3-year period population-based prospective cohort study.British journal of clinical pharmacology · 2020Article
- Rivaroxaban was found to be noninferior to warfarin in routine clinical care: A retrospective noninferiority cohort replication study.Pharmacoepidemiology and drug safety · 2020Article
- Major bleeding risk and mortality associated with antiplatelet drugs in real-world clinical practice. A prospective cohort study.PloS one · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundValidation studies on an ICD-10-based algorithm to identify major bleeding events are scarce, and mostly focused on positive predictive values.
objectiveTo evaluate the sensitivity and specificity of an ICD-10-based algorithm in adult patients referred to hospital.
methodsThis was a cross-sectional, retrospective analysis. Among all hospital stays of adult patients referred to Rennes University Hospital, France, through the emergency ward in 2014, we identified major bleeding events according to an index test based on a list of ICD-10 diagnoses. As a reference, a two-step process was applied: firstly, a computerized request for electronic health records from the emergency ward, using several hemorrhage-related diagnostic codes and specific emergency therapies so as to discard stays with a very low probability of bleeding; secondly, a chart review of selected records was conducted by a medical expert blinded to the index test results and each hospital stay was classified into one of two exclusive categories: major bleeding or no major bleeding, according to pre-specified criteria.
resultsOut of 16,012 hospital stays, the reference identified 736 major bleeding events and left 15,276 stays considered as without the target condition. The index test identified 637 bleeding events: 293 intracranial hemorrhages, 197 gastrointestinal hemorrhages and 147 other bleeding events. Overall, sensitivity was 65% (95%CI, 62 to 69), and specificity was 99.0%. We observed differential sensitivity and specificity across bleeding types, with the highest values for intracranial hemorrhage. Positive predictive values ranged from 59% for "other" bleeding events, to 71% (95%CI, 65 to 78) for gastrointestinal hemorrhage, and 96% for intracranial hemorrhage.
conclusionsLow sensitivity and differential measures of accuracy across bleeding types support the need for specific data collection and medical validation rather than using an ICD-10-based algorithm for assessing the incidence of major bleeding.
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