• Sarah Cohen, Anne-Sophie Jannot, Laurence Iserin, Damien Bonnet, Anita Burgun, and Jean-Baptiste Escudié.
• Inserm-UMRS 1138, Team 22, Cordeliers Research Centre, Paris Descartes University, 15, rue de l'École de Médecine, 75006 Paris, France. Electronic address: sarah.cohen.hegp@gmail.com.
• Arch Cardiovasc Dis. 2019 Jan 1; 112 (1): 31-43.

BackgroundThe content of electronic medical records (EMRs) encompasses both structured data, such as billing codes, and unstructured data, including free-text reports. Epidemiological and clinical research into adult congenital heart disease (ACHD) increasingly relies on administrative claim data using the International Classification of Diseases (9th revision) (ICD-9). In France, administrative databases use ICD-10, the reliability of which is largely unknown in this context.AimsTo assess the accuracy of ICD-10 codes retrieved from administrative claim data in the identification and classification of ACHD.MethodsWe randomly included 6000 patients hospitalized at least once in 2000-2014 in a cardiology department with a dedicated specialized ACHD Unit. For each patient, the clinical diagnosis extracted from the EMR was compared with the assigned ICD-10 codes. Performance of ICD-10 codes in the identification and classification of ACHD was assessed by estimating sensitivity, specificity and positive predictive value.ResultsAmong the 6000 patients included, 780 (13%) patients with ACHD were manually identified from EMRs (107,092 documents). ICD-10 codes correctly categorized 629 as having ACHD (sensitivity 0.81, 95% confidence interval 0.78-0.83), with a specificity of 0.99 (95% confidence interval 0.99-1). The performance of ICD-10 codes in correctly categorizing the ACHD defect subtype depended on the defect, with sensitivity ranging from 0 (e.g. unspecified congenital malformation of tricuspid valve) to 1 (e.g. common arterial trunk), and specificity ranging from 0.99 to 1.ConclusionsAdministrative data using ICD-10 codes is a precise tool for detecting ACHD, and may be used to establish a national cohort. Mining free-text reports in addition to coded administrative data may offset the lack of sensitivity and accuracy when describing the spectrum of congenital heart disease using ICD-10 codes.Copyright © 2018. Published by Elsevier Masson SAS.

26 keywords...

hide…