Validity of administrative database code algorithms to identify vascular access placement, surgical revisions, and secondary patency
| Autor: | Ahmed A. Al-Jaishi, Amit X. Garg, Danielle M. Nash, Louise Moist, Charmaine E. Lok, Jamie L. Fleet, Matthew J. Oliver |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Catheter Obstruction Male Catheterization Central Venous Databases Factual Secondary patency 030232 urology & nephrology Vascular access 030204 cardiovascular system & hematology 03 medical and health sciences Arteriovenous Shunt Surgical Patient Admission 0302 clinical medicine International Classification of Diseases Renal Dialysis Administrative database Code (cryptography) Data Mining Humans Medicine Vascular Patency Aged Aged 80 and over Ontario business.industry Graft Occlusion Vascular Reproducibility of Results Middle Aged medicine.disease Treatment Outcome Nephrology Hospital admission Female Surgery Medical emergency business Administrative Claims Healthcare Algorithms |
| Zdroj: | The Journal of Vascular Access. 19:561-568 |
| ISSN: | 1724-6032 1129-7298 |
| DOI: | 10.1177/1129729818762008 |
| Popis: | Background: We assessed the validity of physician billing codes and hospital admission using International Classification of Diseases 10th revision codes to identify vascular access placement, secondary patency, and surgical revisions in administrative data. Methods: We included adults (≥18 years) with a vascular access placed between 1 April 2004 and 31 March 2013 at the University Health Network, Toronto. Our reference standard was a prospective vascular access database (VASPRO) that contains information on vascular access type and dates of placement, dates for failure, and any revisions. We used VASPRO to assess the validity of different administrative coding algorithms by calculating the sensitivity, specificity, and positive predictive values of vascular access events. Results: The sensitivity (95% confidence interval) of the best performing algorithm to identify arteriovenous access placement was 86% (83%, 89%) and specificity was 92% (89%, 93%). The corresponding numbers to identify catheter insertion were 84% (82%, 86%) and 84% (80%, 87%), respectively. The sensitivity of the best performing coding algorithm to identify arteriovenous access surgical revisions was 81% (67%, 90%) and specificity was 89% (87%, 90%). The algorithm capturing arteriovenous access placement and catheter insertion had a positive predictive value greater than 90% and arteriovenous access surgical revisions had a positive predictive value of 20%. The duration of arteriovenous access secondary patency was on average 578 (553, 603) days in VASPRO and 555 (530, 580) days in administrative databases. Conclusion: Administrative data algorithms have fair to good operating characteristics to identify vascular access placement and arteriovenous access secondary patency. Low positive predictive values for surgical revisions algorithm suggest that administrative data should only be used to rule out the occurrence of an event. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|