ArticleBMJ open gastroenterology2021
Detecting non-alcoholic fatty liver disease and risk factors in health databases: accuracy and limitations of the ICD-10-AM.
Article in BMJ open gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Characteristics of influenza, SARS-CoV-2, and RSV surveillance systems that utilise ICD-coded data: a systematic review.Journal of global health · 2025Pooled it
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- Tirzepatide versus SGLT2 inhibitors for MASLD: a multi-institutional propensity score-matched cohort study.Hepatology international · 2026Article
- Large Language Models can Identify the Presence of MASH and Extract VCTE Measurements from Unstructured Documentation.Digestive diseases and sciences · 2026Article
- Metabolic dysfunction-associated steatohepatitis in the real world: clinical burden, disease progression, and risk stratification with non-invasive tests.BMC gastroenterology · 2026Article
- Liver cancer risk stratification using deep learning on nationwide longitudinal health screening data: a retrospective cohort study.BMC medical informatics and decision making · 2026Article
- Earlier Menopause and Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Global Cohort Study.Diabetes/metabolism research and reviews · 2026Article
- Metabolic Dysfunction-Associated Steatotic Liver Disease Is Associated With Adverse Social Factors: An Analysis UsingGastro hep advances · 2026Article
- Development of an AI algorithm for early identification of MASLD in the electronic health record.Hepatology communications · 2025Article
- Low-density lipoprotein cholesterol and clinical outcomes in patients with liver cirrhosis: a nationwide cohort study.Annals of medicine · 2025Article
- Cause-specific mortality among Queensland people with cirrhosis, by cirrhosis aetiology and decompensation status, 2007-22: a retrospective cohort study.The Medical journal of Australia · 2025Article
- Obesity drives the link between liver fat and depression: Cross-sectional and prospective investigations.Diabetes, obesity & metabolism · 2025Article
- A nationwide population-based cross-sectional time series study of hospitalized chronic liver disease burden in Thailand from 2017 to 2022.Scientific reports · 2025Article
- A population-based study of cause-specific mortality in First Nations Australians with cirrhosis: impact of cardiometabolic comorbidities and liver disease risk factors.The Lancet regional health. Western Pacific · 2025Article
- Projected Trends in Metabolic Dysfunction-Associated Steatotic Liver Disease Mortality Through 2040.JAMA network open · 2025Article
- Risk of audiologic side effects with teprotumumab treatment for thyroid eye disease: propensity matched analysis.Eye (London, England) · 2025Article
- Physical activity and the risk of cardiovascular disease, cirrhosis, cancer and mortality among individuals with MASLD: a prospective cohort study.BMJ open sport & exercise medicine · 2025Article
- Discovery of biophysical rate laws from the electronic health record enables real-time liver injury estimation from transaminase dynamics.Cell reports. Medicine · 2024Article
- Non-alcoholic fatty liver disease risk with GLP-1 receptor agonists and SGLT-2 inhibitors in type 2 diabetes: a nationwide nested case-control study.Cardiovascular diabetology · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) cirrhosis is often underestimated in healthcare and administrative databases that define disease burden using International Classification of Diseases (ICD) codes. This retrospective audit was conducted to explore the accuracy and limitations of the ICD, Tenth Revision, Australian Modification (ICD-10-AM) to detect NAFLD, metabolic risk factors (obesity and diabetes) and other aetiologies of chronic liver disease. DESIGN/
methodICD-10-AM codes in 308 admitted patient encounters at two major Australian tertiary hospitals were compared with data abstracted from patients' electronic medical records. Accuracy of individual codes and grouped combinations was determined by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Cohen's kappa coefficient (κ).
resultsThe presence of an ICD-10-AM code accurately predicted the presence of NAFLD/NASH (PPV 91.2%) and obesity (PPV 91.6%) in most instances. However, codes underestimated the prevalence of NAFLD/NASH and obesity by 42.9% and 45.3%, respectively. Overall concordance between clinical documentation and 'grouped alcohol' codes (κ 0.75) and hepatitis C codes (κ 0.88) was high. Hepatitis B codes detected false-positive cases in patients with previous exposure (PPV 55.6%). Accuracy of codes to detect diabetes was excellent (sensitivity 95.8%; specificity 97.6%; PPV 94.9%; NPV 98.1%) with almost perfect concordance between codes and documentation in medical records (κ 0.93).
conclusionRecognition of the utility and limitations of ICD-10-AM codes to study the burden of NAFLD/NASH cirrhosis is imperative to inform public health strategies and appropriate investment of resources to manage this burgeoning chronic disease.
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