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Validity of clinical psoriatic arthritis diagnoses made by rheumatologists in the Swedish National Patient Register

Wallman, J. K. LU ; Alenius, G. M. ; Klingberg, E. ; Sigurdardottir, V. ; Wedrén, S. ; Exarchou, S. LU ; Lindström, U. ; Di Giuseppe, D. ; Askling, J. and Jacobsson, L. T.H. (2023) In Scandinavian Journal of Rheumatology 52(4). p.374-384
Abstract

Objectives: : Knowledge of the correspondence between clinical ICD diagnoses and classification criteria fulfilment is crucial to interpret studies identifying cases via ICD codes. We assessed the degree to which patients registered with ICD-10 diagnoses of psoriatic arthritis (PsA) in the Swedish National Patient Register (NPR) fulfil established PsA classification criteria. Method: Four hundred patients with at least one outpatient visit to one of five rheumatology or internal medicine departments (three university/two county departments across Sweden) in 2013–2015, with a main ICD-10 diagnosis of PsA (L40.5–M07.3), were randomly selected (80 cases/site). Through a structured medical record review, positive predictive values (PPVs)... (More)

Objectives: : Knowledge of the correspondence between clinical ICD diagnoses and classification criteria fulfilment is crucial to interpret studies identifying cases via ICD codes. We assessed the degree to which patients registered with ICD-10 diagnoses of psoriatic arthritis (PsA) in the Swedish National Patient Register (NPR) fulfil established PsA classification criteria. Method: Four hundred patients with at least one outpatient visit to one of five rheumatology or internal medicine departments (three university/two county departments across Sweden) in 2013–2015, with a main ICD-10 diagnosis of PsA (L40.5–M07.3), were randomly selected (80 cases/site). Through a structured medical record review, positive predictive values (PPVs) for fulfilment of the following classification criteria were assessed: CASPAR, Moll and Wright, Vasey and Espinoza, and modified ESSG criteria for PsA. A subset analysis regarding CASPAR fulfilment was also performed among cases with available rheumatoid factor and peripheral X-ray status (central CASPAR items; n = 227). Results: Of the 400 patients with a main ICD-10 diagnosis of PsA, 343 (86%) fulfilled at least one of the four PsA classification criteria. PPVs for the different criteria were: CASPAR 69% (82% in the subset analysis), Moll and Wright 51%, Vasey and Espinoza 76%, and modified ESSG 64%. Overall, only 6.5% of the 400 PsA diagnoses were judged as clearly incorrect by the medical record reviewers. Conclusion: The validity of rheumatologist-made, clinical ICD-10 diagnoses for PsA in the Swedish NPR is good, with PPVs of 69–82% for CASPAR fulfilment and 86% for meeting any established PsA classification criteria.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Rheumatology
volume
52
issue
4
pages
374 - 384
publisher
Taylor & Francis
external identifiers
  • pmid:35659437
  • scopus:85131561419
ISSN
0300-9742
DOI
10.1080/03009742.2022.2066807
language
English
LU publication?
yes
id
10979ba8-d93c-4115-8a16-82412aa57f49
date added to LUP
2023-01-13 14:35:46
date last changed
2024-04-18 18:07:38
@article{10979ba8-d93c-4115-8a16-82412aa57f49,
  abstract     = {{<p>Objectives: : Knowledge of the correspondence between clinical ICD diagnoses and classification criteria fulfilment is crucial to interpret studies identifying cases via ICD codes. We assessed the degree to which patients registered with ICD-10 diagnoses of psoriatic arthritis (PsA) in the Swedish National Patient Register (NPR) fulfil established PsA classification criteria. Method: Four hundred patients with at least one outpatient visit to one of five rheumatology or internal medicine departments (three university/two county departments across Sweden) in 2013–2015, with a main ICD-10 diagnosis of PsA (L40.5–M07.3), were randomly selected (80 cases/site). Through a structured medical record review, positive predictive values (PPVs) for fulfilment of the following classification criteria were assessed: CASPAR, Moll and Wright, Vasey and Espinoza, and modified ESSG criteria for PsA. A subset analysis regarding CASPAR fulfilment was also performed among cases with available rheumatoid factor and peripheral X-ray status (central CASPAR items; n = 227). Results: Of the 400 patients with a main ICD-10 diagnosis of PsA, 343 (86%) fulfilled at least one of the four PsA classification criteria. PPVs for the different criteria were: CASPAR 69% (82% in the subset analysis), Moll and Wright 51%, Vasey and Espinoza 76%, and modified ESSG 64%. Overall, only 6.5% of the 400 PsA diagnoses were judged as clearly incorrect by the medical record reviewers. Conclusion: The validity of rheumatologist-made, clinical ICD-10 diagnoses for PsA in the Swedish NPR is good, with PPVs of 69–82% for CASPAR fulfilment and 86% for meeting any established PsA classification criteria.</p>}},
  author       = {{Wallman, J. K. and Alenius, G. M. and Klingberg, E. and Sigurdardottir, V. and Wedrén, S. and Exarchou, S. and Lindström, U. and Di Giuseppe, D. and Askling, J. and Jacobsson, L. T.H.}},
  issn         = {{0300-9742}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{374--384}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Rheumatology}},
  title        = {{Validity of clinical psoriatic arthritis diagnoses made by rheumatologists in the Swedish National Patient Register}},
  url          = {{http://dx.doi.org/10.1080/03009742.2022.2066807}},
  doi          = {{10.1080/03009742.2022.2066807}},
  volume       = {{52}},
  year         = {{2023}},
}