Publication Date
8-25-2020
Journal
Antibiotics
DOI
10.3390/antibiotics9090536
PMID
32854205
PMCID
PMC7558992
PubMedCentral® Posted Date
8-25-2020
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
validation, ICD, urinary tract infection, outpatient, cystitis, PPV
Abstract
OBJECTIVE: To validate the use of electronic algorithms based on International Classification of Diseases (ICD)-10 codes to identify outpatient visits for urinary tract infections (UTI), one of the most common reasons for antibiotic prescriptions.
METHODS: ICD-10 symptom codes (e.g., dysuria) alone or in addition to UTI diagnosis codes plus prescription of a UTI-relevant antibiotic were used to identify outpatient UTI visits. Chart review (gold standard) was performed by two reviewers to confirm diagnosis of UTI. The positive predictive value (PPV) that the visit was for UTI (based on chart review) was calculated for three different ICD-10 code algorithms using (1) symptoms only, (2) diagnosis only, or (3) both.
RESULTS: Of the 1087 visits analyzed, symptom codes only had the lowest PPV for UTI (PPV = 55.4%; 95%CI: 49.3-61.5%). Diagnosis codes alone resulted in a PPV of 85% (PPV = 84.9%; 95%CI: 81.1-88.2%). The highest PPV was obtained by using both symptom and diagnosis codes together to identify visits with UTI (PPV = 96.3%; 95%CI: 94.5-97.9%).
CONCLUSIONS: ICD-10 diagnosis codes with or without symptom codes reliably identify UTI visits; symptom codes alone are not reliable. ICD-10 based algorithms are a valid method to study UTIs in primary care settings.
Included in
Family Medicine Commons, Medical Sciences Commons, Pathological Conditions, Signs and Symptoms Commons, Primary Care Commons, Urology Commons
Comments
Associated Data