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Meta-Analysis
. 2018 Oct 4;9(10):191.
doi: 10.1038/s41424-018-0060-1.

The Use of International Classification of Diseases Codes to Identify Patients with Pancreatitis: A Systematic Review and Meta-analysis of Diagnostic Accuracy Studies

Amy Y Xiao  1 , Marianne L Tan  1 , Maria N Plana  2 , Dhiraj Yadav  3 , Javier Zamora  2   4 , Maxim S Petrov  5
Affiliations
Meta-Analysis

The Use of International Classification of Diseases Codes to Identify Patients with Pancreatitis: A Systematic Review and Meta-analysis of Diagnostic Accuracy Studies

Amy Y Xiao et al. Clin Transl Gastroenterol. .

Erratum in

Abstract

Background: Hospital discharge codes are increasingly used in gastroenterology research, but their accuracy in the setting of acute pancreatitis (AP) and chronic pancreatitis (CP), one of the most frequent digestive diseases, has never been assessed systematically. The aim was to conduct a systematic literature review and determine accuracy of diagnostic codes for AP and CP, as well as the effect of covariates.

Methods: Three databases (Pubmed, EMBASE and Scopus) were searched by two independent reviewers for relevant studies that used International Classification of Disease (ICD) codes. Summary estimates of sensitivity, specificity and positive predictive value were obtained from bivariate random-effects regression models. Sensitivity and subgroup analyses according to recurrence of AP and age of the study population were performed.

Results: A total of 24 cohorts encompassing 18,106 patients were included. The pooled estimates of sensitivity and specificity of ICD codes for AP were 0.85 and 0.96, respectively. The pooled estimates of sensitivity and specificity of ICD codes for CP were 0.75 and 0.94, respectively. The positive predictive value of ICD codes was 0.71 for either AP or CP. It increased to 0.78 when applied to incident episode of AP only. The positive predictive value decreased to 0.68 when the ICD codes were applied to paediatric patients.

Conclusion: Nearly three out of ten patients are misidentified as having either AP or CP with the indiscriminate use of ICD codes. Limiting the use of ICD codes to adult patients with incident episode of AP may improve identification of patients with pancreatitis in administrative databases.

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Conflict of interest statement

Guarantor of the article: Maxim S. Petrov.

Specific author contributions: Data collection: Amy Y. Xiao and Marianne L. Tan; analysis of the data: Amy Y. Xiao, Maria N. Plana and Javier Zamora; drafting the paper: Amy Y. Xiao; critical reviewing of the paper for intellectual content: Maria N. Plana, Dhiraj Yadav, Javier Zamora and Maxim S. Petrov; study supervision: Maxim S. Petrov.

Financial support: COSMOS is supported in part by the Royal Society of New Zealand (Rutherford Discovery Fellowship to Associate Professor Petrov), which played no role in the study design, collection, analysis or interpretation of data or writing of the paper.

Potential competing interests: None.

Figures

Fig. 1
Fig. 1
Flow chart of the study selection process
Fig. 2
Fig. 2
Pooled positive predictive value of ICD codes in identifying patients with acute pancreatitis
Fig. 3
Fig. 3
Pooled sensitivity and specificity of ICD codes in identifying patients with acute pancreatitis
Fig. 4
Fig. 4
Summary receiver operating characteristic (SROC) curve of sensitivity and specificity of ICD codes in identifying patients with acute pancreatitis
Fig. 5
Fig. 5
Pooled positive predictive value of ICD codes in identifying patients with chronic pancreatitis
See this image and copyright information in PMC

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