国际疾病分类的验证 怀孕期间贫血的诊断代码
Anna Booman1, Brian T Bateman1, Sara Siadat1
1Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Paediatric and perinatal epidemiology
|October 30, 2025
概括
国际疾病分类,第10次修订 (ICD-10) 代码对妊娠性贫血显示低敏感性但高特异性. 研究人员应谨慎使用并考虑偏差分析,当仅依靠这些代码来识别产前贫血时.
科学领域:
- 产科和妇科 产科和妇科
- 血液学 血液学 血液学
- 医疗信息学 医疗信息学
背景情况:
- 孕期贫血是一种常见的疾病,与不良周产期结局有关.
- 流行病学研究经常使用国际疾病分类第10版 (ICD-10) 诊断代码来识别怀孕期间的贫血.
- 这些ICD-10代码的诊断准确性尚未得到充分证实.
研究的目的:
- 评估ICD-10诊断代码在怀孕期间识别贫血的有效性.
- 为了将ICD-10代码诊断与实验室测量的血红蛋白和血红素值进行比较.
主要方法:
- 使用了包含保险索赔和实验室值的MerativeTM MarketScan®商业数据库 (2018-2022年).
- 包括记录了血红蛋白或血红素值的怀孕,但不包括具有遗传性贫血诊断码的怀孕.
- 计算了科恩的卡帕,灵敏度,特异性和预测值,以根据已建立的贫血标准评估代码有效性.
主要成果:
- 分析包括了71,160个怀孕.
- 实验室确定的贫血和ICD-10代码之间的一致性是0.258.8.
- 灵敏度低于0.300,而特异性高于0.918.
- 积极的预测值为0.551,负的预测值为0.797.
结论:
- 在大型商业索赔数据库中,产前贫血的ICD-10代码显示出低灵敏度和高特异性.
- 在研究中单独使用ICD-10代码来识别产前贫血时,建议谨慎使用.
- 研究人员应纳入偏差分析,以减轻使用这些代码时的错误分类错误.
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