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Authentication of Algorithm to Detect Metastases in Men with Prostate Cancer Using ICD-9 Codes
Matthew T Dolan1, Sung Kim1,2,3, Yu-Hsuan Shao2,4
1Department of Radiation Oncology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Epidemiology Research International
|October 20, 2017
Summary
A new algorithm using specific ICD-9 codes accurately detects prostate cancer (PCa) metastasis. This method offers high sensitivity and specificity for identifying metastatic PCa in patient records.
Area of Science:
- Oncology
- Medical Informatics
- Health Services Research
Background:
- Metastasis is a critical outcome for prostate cancer (PCa) patients.
- Current methods for detecting PCa metastasis using claims data are not validated.
- Accurate identification of metastasis is essential for patient management and research.
Purpose of the Study:
- To develop and validate a claims-based algorithm for detecting prostate cancer (PCa) metastasis.
- To utilize International Classification of Diseases, Ninth Revision (ICD-9) codes for accurate metastasis reporting.
- To compare the performance of two distinct ICD-9 code-based algorithms.
Main Methods:
- Reviewed medical records of 300 hospitalized prostate cancer (PCa) patients.
- Established chart review as the gold standard for metastatic PCa presence.
- Compared Algorithm A (ICD-9 codes 198.5, 197.0, 197.7, 198.3) against Algorithm B (ICD-9 code 198.5).
- Calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
- Assessed agreement using Kappa statistics.
Main Results:
- Algorithm A achieved 95% sensitivity, 100% specificity, 100% PPV, and 98.7% NPV.
- Algorithm B showed 90% sensitivity, 100% specificity, 100% PPV, and 97.5% NPV.
- Agreement rates were 96.8% for Algorithm A and 93.5% for Algorithm B.
Conclusions:
- The algorithm using ICD-9 codes 198.5, 197.0, 197.7, or 198.3 effectively detects prostate cancer (PCa) metastasis.
- This claims-based approach demonstrates high performance metrics (sensitivity, specificity, PPV, NPV).
- The developed algorithm provides a validated tool for identifying PCa metastasis in administrative data.
