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ICD9-CM Claims Data are Insufficient for Influenza Surveillance
Peter L Elkin1, Steven H Brown2
1Department of Biomedical Informatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY.
International Archives of Medicine
|April 30, 2020
Summary
Influenza diagnosis codes (ICD9-CM) show low accuracy for biosurveillance. Laboratory confirmation is crucial for reliable influenza surveillance, as diagnosis codes alone are insufficient.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Influenza and influenza-like illnesses pose significant public health challenges.
- Early detection through biosurveillance is vital for timely public health responses.
- Current US biosurveillance relies on ICD9 diagnoses and chief complaint data.
Purpose of the Study:
- To evaluate the accuracy of ICD9 diagnoses for influenza.
- To compare ICD9-CM coding against laboratory-confirmed influenza cases.
Main Methods:
- A six-year retrospective cohort study.
- Data collected from a tertiary referral center.
- Analysis of 3,828 patients with ICD9-CM influenza codes and 1,455 with laboratory-confirmed influenza.
Main Results:
- ICD9-CM coding for influenza had a Positive Predictive Value (PPV) of 66.2%.
- The Sensitivity (recall) of ICD9-CM for influenza was 45.6%.
- Only 45.6% of laboratory-confirmed influenza cases were identified using ICD9-CM codes.
Conclusions:
- ICD9-CM codes demonstrate low precision and recall for influenza diagnosis.
- Relying solely on ICD9-CM coded diagnoses is inadequate for effective influenza surveillance.
- Laboratory confirmation is essential for accurate influenza monitoring.
