Strengths and limitations of International Classification of Disease Ninth Revision Clinical Modification codes in defining cervical spine surgery
| Autor: | Melissa Y. Macias, Purusottom W. Laud, Ann B. Nattinger, Marjorie C. Wang |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population Sensitivity and Specificity Medical Records Myelopathy Wisconsin International Classification of Diseases Cervical spondylosis medicine Data Mining Humans Orthopedics and Sports Medicine Orthopedic Procedures Medical diagnosis education Retrospective Studies education.field_of_study Academic Medical Centers business.industry Medical record Laminectomy Reproducibility of Results Retrospective cohort study Gold standard (test) medicine.disease Patient Discharge Surgery Databases as Topic Cervical Vertebrae Spinal Diseases Neurology (clinical) Radiology business Algorithms |
| Zdroj: | Spine. 36(1) |
| ISSN: | 1528-1159 |
| Popis: | Study design Retrospective study. Objective To evaluate the sensitivity and specificity of International Classification of Disease Ninth Revision Clinical Modification (ICD9-CM) hospital discharge codes to define degenerative cervical spine surgery in comparison to patient operative notes in the medical record. Summary of background data Population-based studies of spine surgery have often relied on administrative databases as a primary information source, but little is known about the validity of using ICD9-CM codes to identify these operations. Methods We performed a retrospective study comparing ICD9-CM billing codes to patient operative notes, the gold standard, for patients undergoing spine surgery in 2006 at a single academic center. Results We identified 1090 procedures of which 265 were categorized as cervical spine surgery for degenerative indications based on the operative notes. Compared to operative notes, our ICD9-CM algorithm had high sensitivity and specificity for selecting surgery at the cervical spine level and cervical spine surgery for degenerative indications. Categorization of cases by procedure had high sensitivity and specificity for fusion and surgical approach (>95%). Categorization of cases by primary diagnosis was generally less accurate. Cervical spondylosis with myelopathy was the most sensitive primary diagnosis. Categorization of cases by procedure had high sensitivity and specificity for fusion and surgical approach (≥96%). However, diagnoses such as herniated disc and procedures such as laminectomy had low sensitivity but high specificity. Conclusion The use of our ICD9-CM algorithm to define spine surgery at the cervical spine level, and degenerative cervical spine surgery is highly accurate. Although specific diagnoses codes are mostly insensitive, an ICD9-CM algorithm can be used to study these procedures with reasonable precision. |
| Databáze: | OpenAIRE |
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