The positive predictive value of a hyperkalemia diagnosis in automated health care data
| Autor: | Stanley Xu, Marsha A. Raebel, Christopher M. Blanchette, Leslie Wright, Craig Cheetham, Michael L. Smith, Gwyn Saylor |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Medical Records Systems Computerized Hyperkalemia Epidemiology Angiotensin-Converting Enzyme Inhibitors Spironolactone urologic and male genital diseases Article Angiotensin Receptor Antagonists Automation Predictive Value of Tests Health care Diabetes Mellitus medicine Humans False Positive Reactions Pharmacology (medical) Intensive care medicine False Negative Reactions Aged Mineralocorticoid Receptor Antagonists Retrospective Studies Delivery of Health Care Integrated business.industry nutritional and metabolic diseases Liter Middle Aged Predictive value female genital diseases and pregnancy complications Serum potassium Potassium Female medicine.symptom business |
| Zdroj: | Pharmacoepidemiology and Drug Safety. 19:1204-1208 |
| ISSN: | 1053-8569 |
| DOI: | 10.1002/pds.2030 |
| Popis: | Our objectives were to determine performance of coded hyperkalemia diagnosis at identifying (1) clinically evident hyperkalemia and (2) serum potassium6 mmol/L.This retrospective observational study included 8722 patients with diabetes within an integrated healthcare system who newly initiated an angiotensin converting enzyme inhibitor, angiotensin receptor blocker, or spironolactone. The primary outcome was first hyperkalemia-associated event (hospitalization, emergency department visit or death within 24 hours of coded diagnosis and/or potassium≥6 mmol/L) during the first year of therapy. Medical records were reviewed.Among a random sample of 99 patients not coded as having hyperkalemia, none had hyperkalemia upon record review. Among all 64 patients identified as having hyperkalemia, all had hospitalization or emergency department visit associated with coded diagnosis or elevated potassium. Of 55 with coded diagnosis, 42 (PPV 76%) had clinically evident hyperkalemia; 32 (PPV 58%) had potassium≥6. Of 9 identified using only potassium≥6, 7 (PPV 78%) had clinically evident hyperkalemia.Nearly one-fourth of patients with coded diagnosis do not have clinically evident hyperkalemia and nearly one-half do not have potassium≥6. Because both false positives and negatives occur with coded diagnoses, medical record validation of hyperkalemia-associated outcomes is necessary. |
| Databáze: | OpenAIRE |
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