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Validity of obstructive sleep apnoea diagnoses.

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Summary

The Danish National Patient Register shows high accuracy for obstructive sleep apnoea diagnoses. The International Classification of Diseases, tenth version (ICD-10) code DG4732 has a 93.8% positive predictive value for identifying obstructive sleep apnoea.

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Area of Science:

  • Medical Informatics
  • Epidemiology
  • Sleep Medicine

Background:

  • Healthcare databases are crucial for epidemiological research on sleep apnoea.
  • Accurate diagnostic data is essential for generating reliable evidence.
  • This study evaluates the accuracy of specific ICD-10 codes for sleep apnoea in a Danish healthcare database.

Purpose of the Study:

  • To determine the positive predictive values (PPVs) of International Classification of Diseases, tenth version (ICD-10) codes for "obstructive sleep apnoea" and "sleep apnoea" within the Danish National Patient Register.
  • To assess the suitability of these diagnostic codes for epidemiological research.

Main Methods:

  • A random sample of 100 patients diagnosed with "obstructive sleep apnoea" (ICD-10 DG4732) and 100 with "sleep apnoea" (DG473*) from the Danish National Patient Registry in 2020 was selected.
  • Positive predictive values were calculated using a documented Apnea-Hypopnea Index (AHI) ≥ 5 to confirm diagnoses.
  • Patients referred to the private sector for AHI assessment (n=70) were excluded due to data access limitations.

Main Results:

  • The study included 130 patients: 64 with "obstructive sleep apnoea" and 66 with "sleep apnoea".
  • The PPV for "obstructive sleep apnoea" (DG4732) was 93.8% (95% CI: 85.0-97.5%).
  • The PPV for the broader "sleep apnoea" code (DG473*) was 80.3% (95% CI: 69.2-88.1%).

Conclusions:

  • The ICD-10 code DG4732 demonstrates high validity for identifying obstructive sleep apnoea.
  • The PPV for the general "sleep apnoea" code (DG473*) is lower but still indicates substantial diagnostic accuracy.
  • The "obstructive sleep apnoea" diagnosis code is a reliable data source for epidemiological studies.