Accuracy of identifying pediatric acute bacterial sinusitis diagnoses in outpatient claims data

Area of Science:

• Pediatric Infectious Diseases
• Health Informatics
• Epidemiology

Background:

• Acute bacterial sinusitis is a common outpatient infection in children and adolescents.
• Large healthcare databases are valuable for studying this condition, but the accuracy of using diagnosis codes and prescriptions to identify cases has not been validated.
• Accurate case identification is crucial for reliable research using administrative data.

Purpose of the Study:

• To evaluate the validity of using International Classification of Diseases, 10th Revision (ICD-10) codes along with antibiotic prescriptions to identify new diagnoses of acute bacterial sinusitis in pediatric outpatients.
• To determine the positive predictive value (PPV) of this combined coding and prescription method.

Main Methods:

• A cohort of pediatric patients (0-17 years) with an acute sinusitis diagnosis and antibiotic prescription was identified from a healthcare system's clinical data warehouse.
• Patients were stratified into age groups (0-5, 6-11, 12-17 years), with 50 cases randomly sampled per group.
• Medical records were reviewed by two pediatric infectious diseases physicians to confirm clinician-defined acute bacterial sinusitis diagnoses, and PPVs were calculated.

Main Results:

• The study included 150 pediatric patients, with frontal, maxillary, and unspecified sinuses being the most common sites (88%).
• The algorithm combining ICD-10 codes for acute sinusitis and same-day antibiotic prescriptions demonstrated a high positive predictive value of 92% (95% CI 87%-95%) for identifying clinician-defined acute bacterial sinusitis.
• The PPVs were consistent across all evaluated age strata.

Conclusions:

• International Classification of Diseases, 10th Revision (ICD-10) codes for acute sinusitis, when paired with a same-day antibiotic prescription, exhibit a high positive predictive value in pediatric outpatients.
• This validated method can be reliably used to study new acute bacterial sinusitis diagnoses within healthcare claims databases.
• The findings support the use of this algorithm for epidemiological research on pediatric sinusitis.