Journal Article

Positive predictive value of ICD-10 codes for acute myocardial infarction in Japan: a validation study at a single center

Setoguchi, Soko, Mochizuki, Mayumi, Lee, Seitetz L., Koide, Daisuke, Ando, Takashi, Ooba, Nobuhiro, Kubota, Kiyoshi, Kimura, Koichi

2018

Overview

Background In Japan, several large healthcare databases have become available for research since the early 2000’s. However, validation studies to examine the accuracy of these databases remain scarce. We conducted a validation study in order to estimate the positive predictive value (PPV) of local or ICD-10 codes for acute myocardial infarction (AMI) in Japanese claims. In particular, we examined whether the PPV differs between claims in the Diagnosis Procedure Combination case mix scheme (DPC claims) and in non-DPC claims. Methods We selected a random sample of 200 patients from all patients hospitalized at a large tertiary-care university hospital between January 1, 2009 and December 31, 2011 who had an inpatient claim assigned a local or ICD-10 code for AMI. We used a standardized data abstraction form to collect the relevant information from an electronic medical records system. Abstracted information was then categorized by a single cardiologist as being either definite or not having AMI. Results In a random sample of 200 patients, the average age was 67.7 years and the proportion of males was 78.0%. The PPV of the local or ICD-10 code for AMI was 82.5% in this sample of 200 patients. Further, of 178 patients who had an ICD-10 code for AMI based on any of the 7 types of condition codes in the DPC claims, the PPV was 89.3%, whereas of the 161 patients who had an ICD-10 code for AMI based on any of 3 major types of condition codes in the DPC claims, the PPV was 93.8%. Conclusion The PPV of the local or ICD-10 code for AMI was high for inpatient claims in Japan. The PPV was even higher for the ICD-10 code for AMI for those patients who received AMI care through the DPC case mix scheme. The current study was conducted in a single center, suggesting that a multi-center study involving different types of hospitals is needed in the future. The accuracy of condition codes for DPC claims in Japan may also be worth examining for conditions other than AMI such as stroke.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Accuracy / Acute myocardial infarction / Aged / Cardiology / Case mix / Classification / Clinical coding / Codes / Databases, Factual / Diagnosis / Diagnosis procedure combination / Diagnosis related groups / Disease / DRGs / Electronic health records / Epidemiology / Fee-for-Service Plans / Female / Health Administration / Health care policy / Health Informatics / Health insurance / Health services / Heart attack / Heart attacks / Hospitalization / Hospitals / Hospitals, University / Humans / Identification and classification / Insurance claims / International Classification of Diseases / Japan / Male / Medical diagnosis / Medical records / Medicine / Medicine & Public Health / Middle Aged / Myocardial Infarction - diagnosis / Nursing Research / Patients / Positive predictive value; database / Predictive Value of Tests / Public Health / Quality / Random variables / Reimbursement / Research Article / safety and outcomes / Tertiary Care Centers / Validation studies / Validation study / Validity