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首页> 外文期刊>Pharmacoepidemiology and drug safety >Use of ICD-9 coding as a proxy for stage of disease in lung cancer.
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Use of ICD-9 coding as a proxy for stage of disease in lung cancer.

机译：使用ICD-9编码作为肺癌疾病阶段的代理。

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OBJECTIVE: To determine the validity of using ICD-9-CM codes indicating metastases as a proxy to classify lung cancer patients by stage of disease. RESEARCH DESIGN: This retrospective database analysis used diagnosis codes to classify subjects to either localized or advanced-stage disease and then compared this classification to the tumor registry staging, which was considered as the 'gold standard.' SUBJECTS AND MEASURES: Study subjects included all lung cancer patients treated at our academic institution during 1996-1997, who were also members of a large insurance company. Data were derived from inpatient cancer-related claims linked with our institution's tumor registry data. Advanced-stage disease (stages II to IV) was defined by claims indicating lymph node involvement or metastases (ICD-9 codes 196-199.1). The tumor registry stagings of the disease for these patients were clustered into two groupings, stages 0-I (localized) and stages II-IV (advanced). RESULTS: Tumor registry entries were identified for 66/77 (85.7%) patients. A total of 19 out of 22 local disease patients (sensitivity of 86.4%) and 30 out of 44 advanced disease patients (sensitivity of 68.2%) were classified correctly by ICD-9 code. A total of 19 out of 33 patients with local disease codes (PPV of 57.6%) and 30 out of 33 patients with advanced disease codes (PPV = 90.9%) were properly identified. CONCLUSIONS: For a population of lung cancer patients in an academic institution who were under a private insurance plan, the ICD-9 coding was associated with a sensitivity and positive predictive values that were consistent with previously reported estimates using Medicare-SEER data. The use of such data to classify patients to disease stages should be executed with caution as under-reporting might exist. Continued attention to discharge abstracting will be needed to improve the validity of this technique.
机译：目的：确定使用ICD-9-CM代码（指示转移灶）作为按疾病阶段对肺癌患者进行分类的代理的有效性。研究设计：这项回顾性数据库分析使用诊断代码对受试者进行了局部或晚期疾病分类，然后将该分类与被认为是“黄金标准”的肿瘤登记阶段进行了比较。研究对象和措施：研究对象包括1996-1997年间在我们的学术机构就诊的所有肺癌患者，他们也是大型保险公司的成员。数据来自与我们机构的肿瘤登记数据相关的住院癌症相关索赔。晚期疾病（II至IV期）由表明淋巴结受累或转移的索赔定义（ICD-9代码196-199.1）。这些患者的疾病的肿瘤登记分期分为两个组：0-I期（局部）和II-IV期（高级）。结果：确定了66/77（85.7％）患者的肿瘤登记条目。通过ICD-9代码正确分类了22名局部疾病患者中的19名（敏感性为86.4％）和44名晚期疾病患者中的30名（敏感性为68.2％）。正确识别了33例局部疾病代码患者中的19例（PPV为57.6％）和33例晚期疾病代码患者中的30例（PPV = 90.9％）。结论：对于在私人机构保险计划下的一所学术机构中的肺癌患者群体，ICD-9编码与敏感性和阳性预测值相关，该值与先前报道的使用Medicare-SEER数据的估计值一致。应谨慎使用此类数据将患者分类为疾病阶段，因为可能存在报告不足的情况。为了提高该技术的有效性，将需要继续关注放电抽象。

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