Evidence map›Paper›PMID 33662670›Full record

ArticleDrug and alcohol dependence2021

Identifying individuals with opioid use disorder: Validity of International Classification of Diseases diagnostic codes for opioid use, dependence and abuse.

Pooja Lagisetty, Claire Garpestad, Angela Larkin, Colin Macleod, Derek Antoku, Stephanie Slat, Jennifer Thomas, Victoria Powell, Amy S B Bohnert, Lewei A Lin

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing 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

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

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6 more citing papers are in PubMed but not listed here.

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

10 authors.

Pooja LagisettyDepartment of Internal Medicine, University of Michigan Medical School, University of Michigan, North Campus Research Center, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI, USA; Center for Clinical Management and Research, North Campus Research Center, Ann Arbor VA, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI 48109, USA. Electronic address: lagiset@med.umich.edu.
Claire GarpestadUniversity of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI, USA.
Angela LarkinCenter for Clinical Management and Research, North Campus Research Center, Ann Arbor VA, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI 48109, USA.
Colin MacleodDepartment of Internal Medicine, University of Michigan Medical School, University of Michigan, North Campus Research Center, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI, USA.
Derek AntokuDepartment of Internal Medicine, University of Michigan Medical School, University of Michigan, North Campus Research Center, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI, USA.
Stephanie SlatDepartment of Internal Medicine, University of Michigan Medical School, University of Michigan, North Campus Research Center, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI, USA.
Jennifer ThomasDepartment of Internal Medicine, University of Michigan Medical School, University of Michigan, North Campus Research Center, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI, USA.
Victoria PowellDepartment of Geriatrics and Palliative Care, University of Michigan Medical School, 1500 E. Medical Center Dr, Ann Arbor, MI, USA.
Amy S B BohnertCenter for Clinical Management and Research, North Campus Research Center, Ann Arbor VA, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI 48109, USA; Department of Anesthesiology, University of Michigan Medical School, 1500 E. Medical Center Dr., Ann Arbor, MI, USA.
Lewei A LinCenter for Clinical Management and Research, North Campus Research Center, Ann Arbor VA, 2800 Plymouth Rd, Bldg 16, Room 243, Ann Arbor, MI 48109, USA; Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Center, 2800 Plymouth Rd, Bldg 16, 2nd Fl, Ann Arbor, MI, USA. Electronic address: leweil@med.umich.edu.

Funding

A Tailored Behavioral Intervention To Increase Engagement in Opioid Tapering in Primary Care SettingsK23DA047475 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LAGISETTY, POOJA · 2019 to 2023
$970k
Investigating the role of microRNAs in microglia in a mouse model of Alzheimer’s DiseaseF30AG062043 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KODAMA, LAY · 2018 to 2020
$116k
NIA NIH HHS F30 AG062043NIDA NIH HHS K23 DA047475
6 · The paper itself

Abstract

backgroundPolicy evaluations and health system interventions often utilize International Classification of Diseases (ICD) codes of opioid use, dependence, and abuse to identify individuals with opioid use disorder (OUD) and assess receipt of evidence-based treatments. However, ICD codes may not map directly onto the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) OUD criteria. This study investigates the positive predictive value of ICD codes in identifying patients with OUD.

methodsWe conducted a clinical chart review on a national sample of 520 Veterans assigned ICD-9 or ICD-10 codes for opioid use, dependence, or abuse from 2012 to 2017. We extracted evidence of DSM-5 OUD criteria and opioid misuse from clinical documentation in the month preceding and three months following initial ICD code listing, and categorized patients into: 1) high likelihood of OUD, 2) limited aberrant opioid use, 3) prescribed opioid use without evidence of aberrant use, and 4) insufficient information. Positive predictive value was calculated as the percentage of individuals with these ICD codes meeting high likelihood of OUD criteria upon chart review.

resultsOnly 57.7 % of patients were categorized as high likelihood of OUD; 16.5 % were categorized as limited aberrant opioid use, 18.9 % prescribed opioid use without evidence of aberrant use, and 6.9 % insufficient information.

conclusionsPatients assigned ICD codes for opioid use, dependence, or abuse often lack documentation of meeting OUD criteria. Many receive long-term opioid therapy for chronic pain without evidence of misuse. Robust methods of identifying individuals with OUD are crucial to improving access to clinically appropriate treatment.

Indexed as

Analgesics, OpioidChronic PainDiagnostic and Statistical Manual of Mental DisordersDocumentationFemaleHumansInternational Classification of DiseasesMaleMiddle AgedOpioid-Related DisordersVeteransAnalgesics, OpioidICD codesOpioid dependenceOpioid use disorder

Identifiers

PMID33662670
PMCPMC8409339

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Registered trials

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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.