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A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective
Luke Rudmik1,2, Yuan Xu3, Edward Kukec4
1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. lukerudmik@gmail.com.
A new case definition using administrative claims data for chronic rhinosinusitis (CRS) was developed and validated. This definition, requiring at least two International Classification of Diseases, 9th edition (ICD-9) codes within two years, improves accuracy in pharmacoepidemiological research.
Area of Science:
- Epidemiology
- Health Informatics
Background:
- Pharmacoepidemiological research for chronic rhinosinusitis (CRS) increasingly uses administrative databases.
- Lack of a validated case definition for CRS in these databases can lead to inaccurate cohorts and biased outcomes.
Purpose of the Study:
- To develop and validate a generalizable administrative database case definition for CRS.
- To improve the accuracy of CRS patient cohorts identified through claims data.
Main Methods:
- A random sample of 100 CRS patients and 100 controls were selected and linked to a Canadian physician claims database (2010-2015).
- Seven International Classification of Diseases, 9th edition (ICD-9)-based coding algorithms were evaluated for validity using CRS ICD-9 codes (473.x and 471.x).
Main Results:
- A case definition of ≥2 CRS ICD-9 claims (471.x or 473.x) within 2 years demonstrated balanced validity (77% sensitivity, 79% specificity).
- Application of this definition to claims data identified a CRS cohort of 51,000 patients with consistent demographics and comorbidity rates.
Conclusions:
- The study validated several coding algorithms for identifying CRS in administrative databases.
- A case definition of ≥2 physician claims for CRS (ICD-9 codes 471.x or 473.x) within 2 years offers optimal validity for pharmacoepidemiological research.
- Further validation across different health systems and with larger chart reviews is recommended.
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