ArticleAddiction (Abingdon, England)2024
Performance of International Classification of Disease-10 codes in detecting emergency department patients with opioid misuse.
Article in Addiction (Abingdon, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 12 citations in OpenAlex.
- Erectile dysfunction and subsequent substance abuse: a retrospective cohort study of US non-academic hospitals.Sexual medicine · 2026Article
- Medical Diagnosis, ED Visits, and Hospitalizations for Substance Use in U.S. Children's Hospitals: A Retrospective Multi-Center Cohort Study.Children (Basel, Switzerland) · 2026Article
- Machine learning models to detect opioid misuse in emergency department patients at triage.The American journal of emergency medicine · 2026Article
- Development and evaluation of machine learning models for the detection of emergency department patients with opioid misuse from clinical notes.JAMIA open · 2026Article
- Estimating community-level prevalence of opioid use disorder: Extrapolating from Medicaid claims data and other publicly available data sources in Ohio, USA.Addiction (Abingdon, England) · 2026Article
- Artificial Intelligence for Opioid Safety Surveillance from Clinical Text: A Clinically Focused Review.Journal of clinical medicine · 2026Review
- Hospitalization for carbon monoxide poisoning is associated with substance use and mood disorders.Internal and emergency medicine · 2025Article
- Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Variability in trends of opioid-related hospital utilization among U.S. Adults, 2016-2021 check.EClinicalMedicine · 2025Article
- Machine learning models to detect opioid misuse in Emergency Department patients at triage.medRxiv : the preprint server for health sciences · 2025Article
- Diagnosis and coding of opioid misuse: a systematic scoping review and implementation framework.Pain medicine (Malden, Mass.) · 2025Article
- Medications for opioid use disorder in traditional medicare beneficiaries: associations with age.Health affairs scholar · 2025Article
- Long-Term Opioid Therapy and Risk of Opioid Overdose by Derived Clinical Indication in North Carolina, 2006-2018.Pharmacoepidemiology and drug safety · 2025Article
- Stigmatizing Language in Substance Use-related International Classification of Diseases Codes.Journal of addiction medicineArticle
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsAccurate case discovery is critical for disease surveillance, resource allocation and research. International Classification of Disease (ICD) diagnosis codes are commonly used for this purpose. We aimed to determine the sensitivity, specificity and positive predictive value (PPV) of ICD-10 codes for opioid misuse case discovery in the emergency department (ED) setting. DESIGN AND
settingRetrospective cohort study of ED encounters from January 2018 to December 2020 at an urban academic hospital in the United States. A sample of ED encounters enriched for opioid misuse was developed by oversampling ED encounters with positive urine opiate screens or pre-existing opioid-related diagnosis codes in addition to other opioid misuse risk factors. CASES: A total of 1200 randomly selected encounters were annotated by research staff for the presence of opioid misuse within health record documentation using a 5-point scale for likelihood of opioid misuse and dichotomized into cohorts of opioid misuse and no opioid misuse. MEASUREMENTS: Using manual annotation as ground truth, the sensitivity and specificity of ICD-10 codes entered during the encounter were determined with PPV adjusted for oversampled data. Metrics were also determined by disposition subgroup: discharged home or admitted.
findingsThere were 541 encounters annotated as opioid misuse and 617 with no opioid misuse. The majority were males (54.4%), average age was 47 years and 68.5% were discharged directly from the ED. The sensitivity of ICD-10 codes was 0.56 (95% confidence interval [CI], 0.51-0.60), specificity 0.99 (95% CI, 0.97-0.99) and adjusted PPV 0.78 (95% CI, 0.65-0.92). The sensitivity was higher for patients discharged from the ED (0.65; 95% CI, 0.60-0.69) than those admitted (0.31; 95% CI, 0.24-0.39).
conclusionsInternational Classification of Disease-10 codes appear to have low sensitivity but high specificity and positive predictive value in detecting opioid misuse among emergency department patients in the United States.
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