ArticleJMIR medical informatics2023
Identification of Postpartum Depression in Electronic Health Records: Validation in a Large Integrated Health Care System.
Article in JMIR medical informatics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- Health Care Use and Recurrence Rate in Hemolytic Disease of the Fetus and Newborn: Retrospective Cohort Study.JMIR pediatrics and parenting · 2026Article
- Knowledge, Attitudes, and Management of Postpartum Depression Among Healthcare Professionals in Croatian Primary and Community Care: A Cross-Sectional Survey Study.International journal of environmental research and public health · 2026Article
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- Postpartum Depression Increases the Risk of Childhood Attention Deficit Hyperactivity Disorder Diagnosis.Reproductive sciences (Thousand Oaks, Calif.) · 2025Article
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- Evaluating Bias-Mitigated Predictive Models of Perinatal Mood and Anxiety Disorders.JAMA network open · 2024Article
- Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.JAMA network open · 2024Article
- Association of Postpartum Temperature Exposure with Postpartum Depression: A Retrospective Cohort Study in Southern California.Environmental health perspectives · 2024Article
- Association of Antepartum and Postpartum Air Pollution Exposure With Postpartum Depression in Southern California.JAMA network open · 2023Article
- Association between urban green space and postpartum depression, and the role of physical activity: a retrospective cohort study in Southern California.Lancet regional health. Americas · 2023Article
- Screening for Depression, Anxiety, and Suicidality: Insights From Electronic Health Record Data in an Academic Medical Center.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe accuracy of electronic health records (EHRs) for identifying postpartum depression (PPD) is not well studied.
objectiveThis study aims to evaluate the accuracy of PPD reporting in EHRs and compare the quality of PPD data collected before and after the implementation of the International Classification of Diseases, Tenth Revision (ICD-10) coding in the health care system.
methodsInformation on PPD was extracted from a random sample of 400 eligible Kaiser Permanente Southern California patients' EHRs. Clinical diagnosis codes and pharmacy records were abstracted for two time periods: January 1, 2012, through December 31, 2014 (International Classification of Diseases, Ninth Revision [ICD-9] period), and January 1, 2017, through December 31, 2019 (ICD-10 period). Manual chart reviews of clinical records for PPD were considered the gold standard and were compared with corresponding electronically coded diagnosis and pharmacy records using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Kappa statistic was calculated to measure agreement.
resultsOverall agreement between the identification of depression using combined diagnosis codes and pharmacy records with that of medical record review was strong (κ=0.85, sensitivity 98.3%, specificity 83.3%, PPV 93.7%, NPV 95.0%). Using only diagnosis codes resulted in much lower sensitivity (65.4%) and NPV (50.5%) but good specificity (88.6%) and PPV (93.5%). Separately, examining agreement between chart review and electronic coding among diagnosis codes and pharmacy records showed sensitivity, specificity, and NPV higher with prescription use records than with clinical diagnosis coding for PPD, 96.5% versus 72.0%, 96.5% versus 65.0%, and 96.5% versus 65.0%, respectively. There was no notable difference in agreement between ICD-9 (overall κ=0.86) and ICD-10 (overall κ=0.83) coding periods.
conclusionsPPD is not reliably captured in the clinical diagnosis coding of EHRs. The accuracy of PPD identification can be improved by supplementing clinical diagnosis with pharmacy use records. The completeness of PPD data remained unchanged after the implementation of the ICD-10 diagnosis coding.
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