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Comparing reliability of ICD-10-based COVID-19 comorbidity data to manual chart review, a retrospective

Joseph W Schaefer1, Joshua M Riley1, Michael Li2

  • 1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Journal of Medical Virology
|December 1, 2021
PubMed

Insights

International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) codes for COVID-19 comorbidities vary in accuracy. Discharge billing diagnoses offer the highest sensitivity, but all methods require careful data source selection and validation.

Area of Science:

  • Medical Informatics
  • Health Services Research
  • Epidemiology

Background:

  • Characterizing comorbidities in patient cohorts is crucial for research.
  • International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) codes are widely used for this purpose.
  • Standardized methods for extracting ICD-10-based comorbidity data are lacking in recent literature.

Purpose of the Study:

  • To compare comorbidity data derived from manual chart review versus ICD-10 codes in COVID-19 cohorts.
  • To evaluate the accuracy of different ICD-10 code extraction methods.
  • To assess the temporal accuracy of ICD-10 codes relative to critical clinical time points like admission.

Main Methods:

  • Retrospective cross-sectional study design.
  • Performance characteristics of ICD-10-based data were compared against manual chart review.
  • Sensitivity analysis was conducted for various data sources and time points.

Main Results:

  • Discharge billing diagnoses demonstrated the highest sensitivity (0.82) for comorbidity identification.
  • The past medical history table showed a sensitivity of 0.72.
  • The active problem list had a sensitivity of 0.67, which decreased significantly on the day of admission (0.58).

Conclusions:

  • The accuracy of ICD-10-based comorbidity data is variable, influenced by the specific comorbidity, data source, and retrieval timing.
  • Opportunities exist to improve the performance of ICD-10 code extraction.
  • Future research must clearly define comorbidity data sources and validate them against manual chart reviews.

Keywords:
COVID-19International Classification of Diseasescomorbidityelectronic health recordsresearch design

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