Evidence map›Paper›PMID 39645154›Full record

ArticleAmerican journal of preventive medicine2025

Using ICD Codes Alone May Misclassify Overdoses Among Perinatal People.

Amy Board, Alana Vivolo-Kantor, Shin Y Kim, Emmy L Tran, Shawn A Thomas, Mishka Terplan, Marcela C Smid, Pilar M Sanjuan, Tanner Wright, Autumn Davidson and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of preventive medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

15 authors.

Amy BoardDivision of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: ocg3@cdc.gov.
Alana Vivolo-KantorDivision of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Shin Y KimDivision of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Emmy L TranDivision of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Shawn A ThomasDivision of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Mishka TerplanFriends Research Institute, Baltimore, Maryland.
Marcela C SmidUniversity of Utah Health, Salt Lake City, Utah.
Pilar M SanjuanDepartment of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
Tanner WrightUniversity of South Florida, Tampa, Florida.
Autumn DavidsonCenter for Health Research-Northwest, Kaiser Permanente, Portland, Oregon.
Elisha M WachmanDepartment of Pediatrics, Boston Medical Center, Boston, Massachusetts.
Kara M RoodThe Ohio State University, Columbus, Ohio.
Diane MorseUniversity of Rochester School of Medicine, Rochester, New York.
Emily ChuDepartment of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
Kathryn MieleDivision of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

introductionAs perinatal drug overdoses continue to rise, reliable approaches are needed to monitor overdose trends during pregnancy and postpartum. This analysis aimed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of ICD-9/10-CM codes for drug overdose events among people in the MATernaL and Infant clinical NetworK (MAT-LINK) with medication for opioid use disorder during pregnancy.

methodsPeople included in this analysis had electronic health record documentation of medication for opioid use disorder and a known pregnancy outcome from January 1, 2014, through August 31, 2021. Data were analyzed during pregnancy through 1 year postpartum. The Centers for Disease Control and Prevention's drug overdose case definitions were used to categorize overdose based on ICD-9/10-CM codes. These codes were compared to abstracted electronic health record data of any drug overdose. Analyses were conducted between May 2023 and May 2024.

resultsAmong 3,911 pregnancies with electronic health record-documented medication for opioid use disorder, the sensitivity of ICD-9/10-CM codes for capturing drug overdose during pregnancy was 32.7%, while specificity was 98.5%, positive predictive value was 23.4%, and negative predictive value was 99.0%. The sensitivity of ICD-9/10-CM codes for capturing drug overdose postpartum was 30.9%, while specificity was 98.4%, positive predictive value was 25.9%, and negative predictive value was 98.8%.

conclusionsThe sensitivity and positive predictive value of ICD-9/10-CM codes for capturing drug overdose compared with abstracted electronic health record data during the perinatal period was low in this cohort of people with medication for opioid use disorder during pregnancy, though the specificity and negative predictive value were high. Incorporating other data from electronic health records and outside the healthcare system might provide more comprehensive insights on nonfatal drug overdose in this population.

Indexed as

Drug OverdoseInternational Classification of DiseasesOpioid-Related DisordersPregnancy ComplicationsAdultElectronic Health RecordsFemaleHumansPregnancySensitivity and SpecificityUnited StatesYoung Adult

Identifiers

PMID39645154
PMCPMC11897912

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.