Evidence map›Paper›PMID 38896072›Full record

ArticleHepatology communications2024

Validating new coding algorithms to improve identification of alcohol-associated and nonalcohol-associated cirrhosis hospitalizations in administrative databases.

Liam A Swain, Jenny Godley, Mayur Brahmania, Juan G Abraldes, Karen L Tang, Jennifer Flemming, Abdel Aziz Shaheen

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Liam A SwainDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Jenny GodleyDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Mayur BrahmaniaDepartment of Medicine, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Juan G AbraldesLiver Unit, Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.
Karen L TangDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Jennifer FlemmingDepartment of Medicine and Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
Abdel Aziz ShaheenDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0002-2940-897

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlcohol (AC) and nonalcohol-associated cirrhosis (NAC) epidemiology studies are limited by available case definitions. We compared the diagnostic accuracy of previous and newly developed case definitions to identify AC and NAC hospitalizations.

methodsWe randomly selected 700 hospitalizations from the 2008 to 2022 Canadian Discharge Abstract Database with alcohol-associated and cirrhosis-related International Classification of Diseases 10th revision codes. We compared standard approaches for AC (ie, AC code alone and alcohol use disorder and nonspecific cirrhosis codes together) and NAC (ie, NAC codes alone) case identification to newly developed approaches that combine standard approaches with new code combinations. Using electronic medical record review as the reference standard, we calculated case definition positive and negative predictive values, sensitivity, specificity, and AUROC.

resultsElectronic medical records were available for 671 admissions; 252 had confirmed AC and 195 NAC. Compared to previous AC definitions, the newly developed algorithm selecting for the AC code, alcohol-associated hepatic failure code, or alcohol use disorder code with a decompensated cirrhosis-related condition or NAC code provided the best overall positive predictive value (91%, 95% CI: 87-95), negative predictive value (89%, CI: 86-92), sensitivity (81%, CI: 76-86), specificity (96%, CI: 93-97), and AUROC (0.88, CI: 0.85-0.91). Comparing all evaluated NAC definitions, high sensitivity (92%, CI: 87-95), specificity (82%, CI: 79-86), negative predictive value (96%, CI: 94-98), AUROC (0.87, CI: 0.84-0.90), but relatively low positive predictive value (68%, CI: 62-74) were obtained by excluding alcohol use disorder codes and using either a NAC code in any diagnostic position or a primary diagnostic code for HCC, unspecified/chronic hepatic failure, esophageal varices without bleeding, or hepatorenal syndrome.

conclusionsNew case definitions show enhanced accuracy for identifying hospitalizations for AC and NAC compared to previously used approaches.

Indexed as

AlgorithmsDatabases, FactualElectronic Health RecordsHospitalizationLiver CirrhosisLiver Cirrhosis, AlcoholicAdultAgedCanadaClinical CodingFemaleHumansInternational Classification of DiseasesMaleMiddle AgedSensitivity and Specificity

Identifiers

PMID38896072
PMCPMC11186834

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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.