ArticleJournal of pain and symptom management2023
Validation of Electronic Health Record-Based Algorithms to Identify Specialist Palliative Care Within the Department of Veterans Affairs.
Article in Journal of pain and symptom management, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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Who cites it
10 citing papers in PubMed, 10 citations in OpenAlex.
- Optimizing outpatient pharmacologic treatment for veterans with alcohol use disorder using an academic detailing approach for primary care providers in the United States Department of Veterans Affairs: A retrospective quasi-experimental study.Addiction (Abingdon, England) · 2026Article
- Agreement Between Self-Reported and Proxy-Reported Pain in Veterans With Advanced Heart Failure.The American journal of hospice & palliative care · 2026Article
- Characterizing Home-Based Primary Care, Palliative, and Hospice Cohorts to Optimize Service Integration and Referral Timing.Journal of the American Geriatrics Society · 2026Article
- Pain Outcomes Among Medical Centers With High vs Low Specialist Palliative Care Reach Among People With Heart Failure.The American journal of hospice & palliative care · 2025Article
- Temporal Trends, Setting, and Timing of Palliative and Hospice Care in COPD in the Veterans Health Administration, 2010-2020.CHEST pulmonary · 2025Article
- Difference-Making Factors Linked to Higher Reach of Specialist Palliative Care Among People With Heart Failure Across a National Sample of VA Medical Centers.The American journal of hospice & palliative care · 2025Article
- Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study.Journal of palliative medicine · 2024Observational
- Veterans' use of inpatient and outpatient palliative care: The national landscape.Journal of the American Geriatrics Society · 2024Article
- Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs.Journal of pain and symptom management · 2024Article
- Trends in Palliative Care Utilization in Deceased Veterans With Heart Failure.Palliative medicine reports · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe measurement of specialist palliative care (SPC) across Department of Veterans Affairs (VA) facilities relies on algorithms applied to administrative databases. However, the validity of these algorithms has not been systematically assessed. MEASURES: In a cohort of people with heart failure identified by ICD 9/10 codes, we validated the performance of algorithms to identify SPC consultation in administrative data and differentiate outpatient from inpatient encounters.
interventionWe derived separate samples of people by receipt of SPC using combinations of stop codes signifying specific clinics, current procedural terminology (CPT), a variable representing encounter location, and ICD-9/ICD-10 codes for SPC. We calculated sensitivity, specificity, and positive and negative predictive values (PPV, NPV) for each algorithm using chart review as the reference standard. OUTCOMES: Among 200 people who did and did not receive SPC (mean age = 73.9 years (standard deviation [SD] = 11.5), 98% male, 73% White), the validity of the stop code plus CPT algorithm to identify any SPC consultation was: Sensitivity = 0.89 (95% Confidence Interval [CI] 0.82-0.94), Specificity = 1.0 [0.96-1.0], PPV = 1.0 [0.96-1.0], NPV = 0.93 [0.86-0.97]. The addition of ICD codes increased sensitivity but decreased specificity. Among 200 people who received SPC (mean age = 74.2 years [SD = 11.8], 99% male, 71% White), algorithm performance in differentiating outpatient from inpatient encounters was: Sensitivity = 0.95 (0.88-0.99), Specificity = 0.81 (0.72-0.87), PPV = 0.38 (0.29-0.49), and NPV = 0.99 (0.95-1.0). Adding encounter location improved the sensitivity and specificity of this algorithm.
conclusionsVA algorithms are highly sensitive and specific in identifying SPC and in differentiating outpatient from inpatient encounters. These algorithms can be used with confidence to measure SPC in quality improvement and research across the VA.
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