Abstract
Background
We conducted a systematic review to identify existing ICD-10 coding validation studies in progressive supranuclear palsy and corticobasal syndrome [PSP/CBS]) and, in a new study, evaluated the accuracy of ICD-10 diagnostic codes for PSP/CBS in Scottish hospital inpatient and death certificate data.
Methods
Original studies that assessed the accuracy of specific ICD-10 diagnostic codes in PSP/CBS were sought. Separately, we estimated the positive predictive value (PPV) of specific codes for PSP/CBS in inpatient hospital data (SMR01, SMR04) compared to clinical diagnosis in four regions. Sensitivity was assessed in one region due to a concurrent prevalence study. For PSP, the consistency of the G23.1 code in inpatient and death certificate coding was evaluated across Scotland.
Results
No previous ICD-10 validation studies were identified. 14,767 records (SMR01) and 1497 records (SMR04) were assigned the candidate ICD-10 diagnostic codes between February 2011 and July 2019. The best PPV was achieved with G23.1 (1.00, 95% CI 0.93–1.00) in PSP and G23.9 in CBS (0.20, 95% CI 0.04–0.62). The sensitivity of G23.1 for PSP was 0.52 (95% CI 0.33–0.70) and G31.8 for CBS was 0.17 (95% CI 0.05–0.45). Only 38.1% of deceased G23.1 hospital-coded cases also had this coding on their death certificate: the majority (49.0%) erroneously assigned the G12.2 code.
Discussion
The high G23.1 PPV in inpatient data shows it is a useful tool for PSP case ascertainment, but death certificate coding is inaccurate. The PPV and sensitivity of existing ICD-10 codes for CBS are poor due to a lack of a specific code.
We conducted a systematic review to identify existing ICD-10 coding validation studies in progressive supranuclear palsy and corticobasal syndrome [PSP/CBS]) and, in a new study, evaluated the accuracy of ICD-10 diagnostic codes for PSP/CBS in Scottish hospital inpatient and death certificate data.
Methods
Original studies that assessed the accuracy of specific ICD-10 diagnostic codes in PSP/CBS were sought. Separately, we estimated the positive predictive value (PPV) of specific codes for PSP/CBS in inpatient hospital data (SMR01, SMR04) compared to clinical diagnosis in four regions. Sensitivity was assessed in one region due to a concurrent prevalence study. For PSP, the consistency of the G23.1 code in inpatient and death certificate coding was evaluated across Scotland.
Results
No previous ICD-10 validation studies were identified. 14,767 records (SMR01) and 1497 records (SMR04) were assigned the candidate ICD-10 diagnostic codes between February 2011 and July 2019. The best PPV was achieved with G23.1 (1.00, 95% CI 0.93–1.00) in PSP and G23.9 in CBS (0.20, 95% CI 0.04–0.62). The sensitivity of G23.1 for PSP was 0.52 (95% CI 0.33–0.70) and G31.8 for CBS was 0.17 (95% CI 0.05–0.45). Only 38.1% of deceased G23.1 hospital-coded cases also had this coding on their death certificate: the majority (49.0%) erroneously assigned the G12.2 code.
Discussion
The high G23.1 PPV in inpatient data shows it is a useful tool for PSP case ascertainment, but death certificate coding is inaccurate. The PPV and sensitivity of existing ICD-10 codes for CBS are poor due to a lack of a specific code.
| Original language | English |
|---|---|
| Number of pages | 9 |
| Journal | Journal of Neurology |
| Early online date | 12 Apr 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 12 Apr 2024 |
Bibliographical note
FundingChief Scientist Ofce (CSO) of the Scottish Government, PSP Association (Grant CAF/PSP/16/01).
Data Availability Statement
Anonymised data relevant to the analyses within this article can be shared at the request of qualifed investigators to replicate presented analyses.Keywords
- progressive supranuclear palsy
- corticobasal degeneration
- positive predictive value
- sensitivity
- ICD-10
- diagnostic codes
- Death certificate