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A systematic review of validated methods for identifying transverse myelitis using administrative or claims data
S Elizabeth Williams1, Ryan Carnahan2, Shanthi Krishnaswami3
1Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, USA.
Purpose:
To identify and assess billing, procedural, or diagnostic code algorithms used to identify transverse myelitis in administrative databases.
Methods:
We searched the MEDLINE database from 1991 to September 2012 using controlled vocabulary and key terms related to transverse myelitis. We also searched the reference lists of included studies. Two investigators independently assessed the full text of studies against pre-determined inclusion criteria. Two reviewers independently extracted data regarding participant and algorithm characteristics.
Results:
Three studies met criteria for inclusion in this review. The only algorithm based solely on administrative claims data with a reported positive predictive value included five ICD-9 codes (codes 341.20, 341.21, 341.22, 323.8, 323.9). The positive predictive value for physician-diagnosed acute transverse myelitis was 62%.
Conclusions:
More research is needed to establish an accurate algorithm to identify transverse myelitis in large administrative databases using diagnosis and/or procedure codes. Use of standardized consensus definitions, clear description for algorithm selection, and reporting of validation procedure and results would be most beneficial.
