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A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective
Author(s) -
Rudmik Luke,
Xu Yuan,
Kukec Edward,
Liu Mingfu,
Dean Stafford,
Quan Hude
Publication year - 2016
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21801
Subject(s) - medicine , guideline , cohort , diagnosis code , chronic rhinosinusitis , icd 10 , coding (social sciences) , asthma , family medicine , psychiatry , statistics , pathology , population , environmental health , mathematics
Background Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD‐9)‐coded claims. Methods A random sample of 100 patients with a guideline‐based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015. The proportion of CRS ICD‐9–coded claims (473.x and 471.x) for each of these 200 patients were reviewed and the validity of 7 different ICD‐9–based coding algorithms was evaluated. Results The CRS case definition of ≥2 claims with a CRS ICD‐9 code (471.x or 473.x) within 2 years of the reference case provides a balanced validity with a sensitivity of 77% and specificity of 79%. Applying this CRS case definition to the claims database produced a CRS cohort of 51,000 patients with characteristics that were consistent with published demographics and rates of comorbid asthma, allergic rhinitis, and depression. Conclusion This study has validated several coding algorithms; based on the results a case definition of ≥2 physician claims of CRS (ICD‐9 of 471.x or 473.x) within 2 years provides an optimal level of validity. Future studies will need to validate this administrative case definition from different health system perspectives and using larger retrospective chart reviews from multiple providers.