Validity of registration of ICD codes and prescriptions in a research database in Swedish primary care: a cross-sectional study in Skaraborg primary care database
Hjerpe, Per LU ; Merlo, Juan LU
; Ohlsson, Henrik
LU
; Bostrom, Kristina Bengtsson
and Lindblad, Ulf
(2010)
In BMC Medical Informatics and Decision Making
10.
- Abstract
- Background: In recent years, several primary care databases recording information from computerized medical records have been established and used for quality assessment of medical care and research. However, to be useful for research purposes, the data generated routinely from every day practice require registration of high quality. In this study we aimed to investigate (i) the frequency and validity of ICD code and drug prescription registration in the new Skaraborg primary care database (SPCD) and (ii) to investigate the sources of variation in this registration. Methods: SPCD contains anonymous electronic medical records (ProfDoc III) automatically retrieved from all 24 public health care centres (HCC) in Skaraborg, Sweden. The... (More)
- Background: In recent years, several primary care databases recording information from computerized medical records have been established and used for quality assessment of medical care and research. However, to be useful for research purposes, the data generated routinely from every day practice require registration of high quality. In this study we aimed to investigate (i) the frequency and validity of ICD code and drug prescription registration in the new Skaraborg primary care database (SPCD) and (ii) to investigate the sources of variation in this registration. Methods: SPCD contains anonymous electronic medical records (ProfDoc III) automatically retrieved from all 24 public health care centres (HCC) in Skaraborg, Sweden. The frequencies of ICD code registration for the selected diagnoses diabetes mellitus, hypertension and chronic cardiovascular disease and the relevant drug prescriptions in the time period between May 2002 and October 2003 were analysed. The validity of data registration in the SPCD was assessed in a random sample of 50 medical records from each HCC (n = 1200 records) using the medical record text as gold standard. The variance of ICD code registration was studied with multi-level logistic regression analysis and expressed as median odds ratio (MOR). Results: For diabetes mellitus and hypertension ICD codes were registered in 80-90% of cases, while for congestive heart failure and ischemic heart disease ICD codes were registered more seldom (60-70%). Drug prescription registration was overall high (88%). A correlation between the frequency of ICD coded visits and the sensitivity of the ICD code registration was found for hypertension and congestive heart failure but not for diabetes or ischemic heart disease. The frequency of ICD code registration varied from 42 to 90% between HCCs, and the greatest variation was found at the physician level (MORPHYSICIAN = 4.2 and MORHCC = 2.3). Conclusions: Since the frequency of ICD code registration varies between different diagnoses, each diagnosis must be separately validated. Improved frequency and quality of ICD code registration might be achieved by interventions directed towards the physicians where the greatest amount of variation was found. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1618889
- author
- Hjerpe, Per
LU
; Merlo, Juan
LU
; Ohlsson, Henrik
LU
; Bostrom, Kristina Bengtsson
and Lindblad, Ulf
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BMC Medical Informatics and Decision Making
- volume
- 10
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000277515500001
- scopus:77951103079
- ISSN
- 1472-6947
- DOI
- 10.1186/1472-6947-10-23
- project
- Social Pharmacoepidemiology
- language
- English
- LU publication?
- yes
- id
- dd0bf105-3c36-428a-9067-5146c6477177 (old id 1618889)
- date added to LUP
- 2016-04-01 13:55:13
- date last changed
- 2022-03-29 18:11:49
@article{dd0bf105-3c36-428a-9067-5146c6477177,
abstract = {{Background: In recent years, several primary care databases recording information from computerized medical records have been established and used for quality assessment of medical care and research. However, to be useful for research purposes, the data generated routinely from every day practice require registration of high quality. In this study we aimed to investigate (i) the frequency and validity of ICD code and drug prescription registration in the new Skaraborg primary care database (SPCD) and (ii) to investigate the sources of variation in this registration. Methods: SPCD contains anonymous electronic medical records (ProfDoc III) automatically retrieved from all 24 public health care centres (HCC) in Skaraborg, Sweden. The frequencies of ICD code registration for the selected diagnoses diabetes mellitus, hypertension and chronic cardiovascular disease and the relevant drug prescriptions in the time period between May 2002 and October 2003 were analysed. The validity of data registration in the SPCD was assessed in a random sample of 50 medical records from each HCC (n = 1200 records) using the medical record text as gold standard. The variance of ICD code registration was studied with multi-level logistic regression analysis and expressed as median odds ratio (MOR). Results: For diabetes mellitus and hypertension ICD codes were registered in 80-90% of cases, while for congestive heart failure and ischemic heart disease ICD codes were registered more seldom (60-70%). Drug prescription registration was overall high (88%). A correlation between the frequency of ICD coded visits and the sensitivity of the ICD code registration was found for hypertension and congestive heart failure but not for diabetes or ischemic heart disease. The frequency of ICD code registration varied from 42 to 90% between HCCs, and the greatest variation was found at the physician level (MORPHYSICIAN = 4.2 and MORHCC = 2.3). Conclusions: Since the frequency of ICD code registration varies between different diagnoses, each diagnosis must be separately validated. Improved frequency and quality of ICD code registration might be achieved by interventions directed towards the physicians where the greatest amount of variation was found.}},
author = {{Hjerpe, Per and Merlo, Juan and Ohlsson, Henrik and Bostrom, Kristina Bengtsson and Lindblad, Ulf}},
issn = {{1472-6947}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Medical Informatics and Decision Making}},
title = {{Validity of registration of ICD codes and prescriptions in a research database in Swedish primary care: a cross-sectional study in Skaraborg primary care database}},
url = {{http://dx.doi.org/10.1186/1472-6947-10-23}},
doi = {{10.1186/1472-6947-10-23}},
volume = {{10}},
year = {{2010}},
}