Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Aug;22(8):842-9.
doi: 10.1002/pds.3447. Epub 2013 May 2.

Validity of diagnostic codes and prevalence of psoriasis and psoriatic arthritis in a managed care population, 1996-2009

Maryam M Asgari  1 , Jashin J Wu, Joel M Gelfand, Craig Salman, Jeffrey R Curtis, Leslie R Harrold, Lisa J Herrinton
Affiliations

Validity of diagnostic codes and prevalence of psoriasis and psoriatic arthritis in a managed care population, 1996-2009

Maryam M Asgari et al. Pharmacoepidemiol Drug Saf. 2013 Aug.

Abstract

Background: Few population-based studies have reported the prevalence of psoriatic disease.

Objective: We validated computerized diagnoses to estimate the prevalence of psoriasis and psoriatic arthritis.

Method: We identified adults with ≥1 ICD-9 diagnosis codes of 696.0 (psoriatic arthritis) or 696.1 (psoriasis) in clinical encounter data during 1996-2009 and used chart review to confirm the diagnoses in random samples of patients. We then used the best performing case-finding algorithms to estimate the point prevalence of psoriasis and psoriatic arthritis.

Results: The number of persons with a diagnosis for psoriasis (ICD-9 code 696.1) was 87 827. Chart review of a random sample of 101 cases with at least one dermatologist-rendered psoriasis code revealed a positive predictive value (PPV) of 90% (95% CI, 83-95) with sensitivity of 88% (95% CI, 80-93). Psoriatic arthritis (code 696.0) was recorded for 5187 patients, with the best performing algorithm requiring ≥2 diagnoses recorded by a rheumatologist or ≥1 diagnosis recorded by a rheumatologist together with ≥1 psoriasis diagnoses recorded by a dermatologist; the PPV was 80% (95% CI, 70-88) with sensitivity 73% (95% CI, 63-82). Among KPNC adults, the point prevalence of psoriasis, with or without psoriatic arthritis, was 939 (95% CI, 765-1142) per 100 000, and the overall prevalence of psoriatic arthritis, with or without psoriasis, was 68 (95% CI, 54-84) per 100 000.

Conclusion: Within an integrated health care delivery system, the use of computerized diagnoses rendered by relevant disease specialists is a valid method for identifying individuals with psoriatic disease.

Keywords: computerized medical information; epidemiology; incidence, prevalence, health maintenance organizations; pharmacoepidemiology; psoriasis; psoriatic arthritis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech and Valeant; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Harrold is an epidemiologic consultant for the Consortium of Rheumatology Researchers of North America (CORRONA). Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Novartis, and is a consultant for Amgen, Abbott, Pfizer, Merck, and CentocorJanssen. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott.

Figures

Figure 1
Figure 1. Age- and sex-specific point prevalence1 per 100,000 persons (shown on Y-axis) of psoriasis with or without psoriatic arthritis (N=55,770) and psoriatic arthritis with or without psoriasis (N=2,941). Men and women aged ≥18 years. Kaiser Permanente Northern California, December 31, 2009
1The prevalence proportions are corrected for the sensitivity and positive predictive value of the validated case-finding algorithms. PsO = psoriasis with or without psoriatic arthritis. PsA = psoriasis with or without psoriasis.
See this image and copyright information in PMC

References

    1. Schön MP, Boehncke WH. Psoriasis. N Engl J Med. 2005;352(18):1899–912. - PubMed
    1. Koo J. Population-based epidemiologic study of psoriasis with emphasis on quality of life assessment. Dermatol Clin. 1996;14(3):485–96. - PubMed
    1. Gelfand JM, Gladman DD, Mease PJ, Smith N, Margolis DJ, Nijsten T, Stern RS, Feldman SR, Rolstad T. Epidemiology of psoriatic arthritis in the population of the United States. J Am Acad Dermatol. 2005;53(4):573. - PubMed
    1. Lima XT, Minnillo R, Spencer JM, Kimball AB. Psoriasis prevalence among the 2009 AAD National Melanoma/Skin Cancer Screening Program participants. J Eur Acad Dermatol Venereol. 2012 Apr 4; doi: 10.1111/j.1468-3083.2012.04531. - DOI - PubMed
    1. Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Time trends in epidemiology and characteristics of psoriatic arthritis over 3 decades: a population-based study. J Rheumatol. 2009;36(2):361–7. - PMC - PubMed

Publication types

MeSH terms