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Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
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Emotionally traumatic events often lead to memories that are exceptionally vivid and enduring, sometimes persisting with remarkable clarity throughout an individual's life. A classic example of this phenomenon is a person who survives a car accident. Even years later, they may recall every detail of the event with startling accuracy — the screeching of the tires, the jarring impact, and the acrid smell of burning rubber. Such vividness contrasts sharply with how an individual...
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Validating administrative records in post-traumatic stress disorder.

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  • 1Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.

International Journal of Methods in Psychiatric Research
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Summary

Administrative coding data (ACD) accuracy for post-traumatic stress disorder (PTSD) diagnosis and pharmacotherapy was assessed. Using three or more PTSD codes in Veterans Health Administration (VHA) data improved accuracy for both diagnosis and treatment assessment.

Keywords:
PTSDmethodologytrauma

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Area of Science:

  • Health Services Research
  • Psychiatry
  • Health Informatics

Background:

  • Accurate identification of post-traumatic stress disorder (PTSD) is crucial for effective veteran care.
  • Administrative coding data (ACD) is widely used but its accuracy for PTSD requires validation.
  • Existing data on the precision of ACD for PTSD diagnosis and treatment is limited.

Purpose of the Study:

  • To evaluate the accuracy of different administrative coding data (ACD) approaches for identifying post-traumatic stress disorder (PTSD) in electronic health records.
  • To determine the positive predictive value (PPV) and negative predictive value (NPV) of ACD strategies for PTSD diagnosis and pharmacotherapy.
  • To provide recommendations for optimizing ACD utilization in the Veterans Health Administration (VHA) for PTSD research.

Main Methods:

  • A retrospective review of medical records was conducted to confirm PTSD diagnosis and treatment.
  • Records were compared against Veterans Health Administration (VHA) administrative coding data (ACD).
  • Three distinct ACD approaches were analyzed for their PPV and NPV in identifying PTSD and related pharmacotherapy.

Main Results:

  • For PTSD diagnosis, an ACD approach using three or more PTSD codes demonstrated high accuracy (PPV 97%, NPV 98%) compared to one or two codes (PPV 78%, NPV 91%).
  • For PTSD pharmacotherapy, using three or more PTSD codes significantly improved accuracy (PPV 85%, NPV 100%) over one or two codes (PPV 33%, NPV 93%).
  • The PPV and NPV varied considerably based on the specific ACD approach employed.

Conclusions:

  • The accuracy of administrative coding data (ACD) for identifying post-traumatic stress disorder (PTSD) and associated pharmacotherapy in VHA data is dependent on the chosen coding strategy.
  • An ACD approach requiring one or more outpatient PTSD encounters is sufficient for identifying a PTSD diagnosis.
  • To accurately assess PTSD-related pharmacotherapy, an ACD strategy identifying veterans with three or more outpatient PTSD encounters is recommended.