Physician adjudication of angioedema diagnosis codes in a population of patients with heart failure prescribed angiotensin‐converting enzyme inhibitor therapy
| Autor: | Sue Hee Sung, Jennifer L. Kuntz, Matthew Slaughter, Alan S. Go, Kristi Reynolds, Raymond G. Schlienger, Jamie H Thompson, Eric S. Johnson, Abraham Markin, Katarzyna Budzynska, Ken J Park, Tiffany Q. Luong, Douglas W. Roblin, Andrea E. Cassidy-Bushrow, Ming-Sum Lee, Sigrid Behr, Albert Yuh-Jer Shen, Elizabeth T. Mansi, David H. Smith, Jaejin An, Micah L. Thorp |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Epidemiology Cardiovascular research Population Angiotensin-Converting Enzyme Inhibitors Cohen's kappa Physicians Internal medicine medicine Humans Pharmacology (medical) cardiovascular diseases Angioedema education Heart Failure education.field_of_study business.industry Reproducibility of Results Angiotensin converting enzyme inhibitor therapy medicine.disease Heart failure ACE inhibitor Diagnosis code medicine.symptom business medicine.drug |
| Zdroj: | Pharmacoepidemiology and Drug Safety. 30:1630-1634 |
| ISSN: | 1099-1557 1053-8569 |
| Popis: | PURPOSE Our objective was to calculate the positive predictive value (PPV) of the ICD-9 diagnosis code for angioedema when physicians adjudicate the events by electronic health record review. Our secondary objective was to evaluate the inter-rater reliability of physician adjudication. METHODS Patients from the Cardiovascular Research Network previously diagnosed with heart failure who were started on angiotensin-converting enzyme inhibitors (ACEI) during the study period (July 1, 2006 through September 30, 2015) were included. A team of two physicians per participating site adjudicated possible events using electronic health records for all patients coded for angioedema for a total of five sites. The PPV was calculated as the number of physician-adjudicated cases divided by all cases with the diagnosis code of angioedema (ICD-9-CM code 995.1) meeting the inclusion criteria. The inter-rater reliability of physician teams, or kappa statistic, was also calculated. RESULTS There were 38 061 adults with heart failure initiating ACEI in the study (21 489 patient-years). Of 114 coded events that were adjudicated by physicians, 98 angioedema events were confirmed for a PPV of 86% (95% CI: 80%, 92%). The kappa statistic based on physician inter-rater reliability was 0.65 (95% CI: 0.47, 0.82). CONCLUSIONS ICD-9 diagnosis code of 995.1 (angioneurotic edema, not elsewhere classified) is highly predictive of angioedema in adults with heart failure exposed to ACEI. |
| Databáze: | OpenAIRE |
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