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使用日本医院数据库验证慢性病的诊断编码
Momiji Otani-Kono1, Shungo Imai2, Masami Tsuchiya1
1Division of Drug Informatics, Faculty of Pharmacy, Keio University, Tokyo, Japan.
Clinical and experimental nephrology
|January 12, 2026
概括
评估了日本慢性病 (CKD) 国际疾病分类第10版 (ICD-10) 代码的有效性. 总体积极预测值 (PPV) 为57.9%,表明使用这些代码诊断CKD的准确性有限.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
背景情况:
- 日本的慢性病 (CKD) 国际疾病分类第10版 (ICD-10) 代码的准确性尚未评估.
- 这项研究解决了在日本医疗保健系统中评估CKD相关ICD-10代码有效性的关键需求.
研究的目的:
- 评估用于识别日本慢性病 (CKD) 患者的ICD-10代码的有效性.
- 确定这些代码的正预测值 (PPV),灵敏度,特异性和负预测值 (NPV).
主要方法:
- 一项回顾性队列研究使用了JMDC医院数据库 (日本).
- 确定了两次血清肌素测量 (间隔90-365天) 的患者;CKD是由病:改善整体结果 (KDIGO) 标准 (eGFR <60 mL/min/1.73 m2) 定义的.
- 计算了与CKD相关的特定ICD-10代码的PPV,灵敏度,特异性和NPV.
主要成果:
- 这项研究包括618,208名患者,59,139人接受了CKD相关的ICD-10代码,172,657人满足了KDIGO标准.
- 总体PPV为57.9%,灵敏度为19.8%,特异性为94.4%,NPV为75.2%.
- 特定的代码 (N183,N184,N185,N189) 显示PPV超过80%.
结论:
- 在日本,CKD的ICD-10代码的整体PPV (57.9%) 低于美国 (86.1%) 和加拿大 (60.1%).
- 尽管整体敏感性有限,但某些ICD-10代码对识别CKD患者具有潜在的实用性.
- 建议对编码实践进行进一步的验证和潜在的改进,以确保准确的CKD监测.
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