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Positive Predictive Value of ICD-10-CM Codes for Myocarditis in Claims Data: A Multi-Institutional Study in Taiwan
Li-Ying Wu1, Shih-Chieh Shao2, Shu-Chen Liao1,3
1Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Clinical Epidemiology
|April 14, 2023
Summary
The accuracy of myocarditis diagnosis codes in Taiwan was acceptable, with an overall positive predictive value of 73.5%. However, misclassifications occurred due to other inflammatory or heart conditions.
Area of Science:
- Medical Informatics
- Cardiology
- Public Health
Background:
- The accuracy of diagnosis codes for identifying myocarditis in healthcare databases is not well-established.
- Accurate coding is crucial for reliable epidemiological research and healthcare quality assessment.
Purpose of the Study:
- To evaluate the coding accuracy of myocarditis using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes in Taiwan.
- To determine the positive predictive value (PPV) of these codes for myocarditis diagnosis.
Main Methods:
- A cross-sectional study was conducted using Taiwan's largest multi-institutional healthcare system.
- Inpatients with new ICD-10-CM myocarditis codes between January 2017 and March 2022 were identified.
- Myocarditis diagnosis was confirmed via gold standard biopsy or electronic medical record review to calculate PPV.
Main Results:
- A total of 498 inpatients were analyzed, with codes I409 and I514 being the most frequent.
- The overall PPV for myocarditis codes was 73.5% (95% CI: 69.6-77.4%).
- Code I409 as a primary diagnosis yielded the highest PPV (96.6%), while 26.5% of cases were false positives, often due to other inflammatory or cardiac conditions.
Conclusions:
- ICD-10-CM codes for myocarditis in Taiwan demonstrate acceptable validity for research purposes.
- Potential for misclassification exists, particularly with other inflammatory diseases, heart failure, or myocardial infarction.
- These findings provide a reference for future studies utilizing secondary healthcare databases for myocarditis research.
Keywords:
Chang Gung Research DatabaseICD-CM-10 codesmulti-institutional studymyocarditispositive predictive valueMore Related Videos
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