在Medicaid分析提取数据库中验证出生体重低和妊娠年龄小的诊断代码
Xi Wang1, Yehua Wang1, Yanmin Zhu2
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida.
American journal of epidemiology
|January 15, 2025
概括
行政医疗记录准确地识别出具有高特异性但对低出生体重 (LBW) 和小于妊娠年龄 (SGA) 敏感度较低的婴儿. 考虑到出生体重并没有改善SGA识别.
科学领域:
- 围产期流行病学 围产期流行病学
- 医疗数据分析 医疗数据分析
- 生物统计学 生物统计学
背景情况:
- 在管理医疗保健数据中准确识别低出生体重 (LBW) 和小于妊娠年龄 (SGA) 的婴儿对于围产期研究至关重要.
- 评估电子健康记录中这些指标准确性的有效性研究有限.
研究的目的:
- 评估ICD-9-CM代码在管理医疗保健数据中识别LBW和SGA婴儿的准确性.
- 评估出生体重归算方法对LBW和SGA识别准确性的影响.
主要方法:
- 将管理数据 (1999-2010 MAX) 与有效妊娠年龄 (GA) 和出生体重 (BW) 的母婴双位数的出生证明 (BC) 联系起来.
- 使用ICD-9-CM代码识别了LBW和SGA,SGA定义为BW<10%的美国参考值.
- 计算了灵敏度,特异性和预测值;使用BC数据和ICD代码边界对LBW诊断的归算出生体重.
主要成果:
- 分析包括1,536,272名活产婴儿.
- ICD-9-CM代码显示敏感度低,但特异性高,以及LBW的负预测值.
- 对于SGA代码,灵敏度为13.36%,特异性为99.01%,积极预测值为67.37%.
- 对LBW代码的出生体重计算使灵敏度增加到22.09%,但使积极预测值降低到41.53%.
结论:
- 行政医疗记录中的ICD-9-CM代码具有高特异性,但对于识别LBW和SGA婴儿的敏感性较低.
- 使用GA和BW数据计算出出生体重并没有显著提高SGA的识别.
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