TITLE

Accuracy of syndrome definitions based on diagnoses in physician claims

AUTHOR(S)
Cadieux, Geneviève; Buckeridge, David L.; Jacques, André; Libman, Michael; Dendukuri, Nandini; Tamblyn, Robyn
PUB. DATE
January 2011
SOURCE
BMC Public Health;2011, Vol. 11 Issue 1, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics. Methods: We selected a random sample of 3,600 community-based primary care physicians who practiced in the fee-for-service system in the province of Quebec, Canada in 2005-2007. We randomly selected 10 visits per physician from their claims, stratifying on syndrome type and presence, diagnosis, and month. Double-blinded chart reviews were conducted by telephone with consenting physicians to obtain information on patient diagnoses for each sampled visit. The sensitivity, specificity, and positive predictive value (PPV) of physician claims were estimated by comparison to chart review. Results: 1,098 (30.5%) physicians completed the chart review. A chart entry on the date of the corresponding claim was found for 10,529 (95.9%) visits. The sensitivity of syndrome definitions based on diagnostic codes in physician claims was low, ranging from 0.11 (fever) to 0.44 (respiratory), the specificity was high, and the PPV was moderate to high, ranging from 0.59 (fever) to 0.85 (respiratory). We found that rarely used diagnostic codes had a higher probability of being false-positives, and that more commonly used diagnostic codes had a higher PPV. Conclusions: Future research should identify physician, patient, and encounter characteristics associated with the accuracy of diagnostic codes in physician claims. This would enable public health to improve syndromic surveillance, either by focusing on physician claims whose diagnostic code is more likely to be accurate, or by using all physician claims and weighing each according to the likelihood that its diagnostic code is accurate.
ACCESSION #
58027180

 

Related Articles

  • Antidepressants and Auto Accidents.  // Critical Care Alert;Dec2012 Clinical Briefs in Primary Care, p2 

    The article presents an analysis of driving simulation tests performed with depression patients who use antidepressants; and specific results for antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic acids (TCA), are provided.

  • Excessive menstruation bleeding as a presentation of dengue hemorrhagic fever. Wiwanitkit, Somsri; Wiwanitkit, Viroj // Archives of Gynecology & Obstetrics;Jun2013, Vol. 287 Issue 6, p1271 

    No abstract available.

  • Clinical studies on hemorrhagic fever with renal syndrome found in Nagoya City University Medical School. Takeuchi, Toshihiko; Yamamoto, Toshiyuki; Itoh, Makoto; Tsukada, Katsuhiko; Yasue, Naoji; Ho Wang Lee // Kidney International Supplement;Dec1991, Issue 35, pS-84 

    Clinical studies of hemorrhagic fever with renal syndrome found in Nagoya City University Medical School. This study refers to the clinical features of 11 cases of hemorrhagic fever with renal syndrome (HFRS) which was prevalent in Nagoya City University Medical School. The clinical course was...

  • Cauda equina syndrome: a serious trap for the urological surgeon. Notley, Richard G. // Clinical Risk;Jul2008, Vol. 14 Issue 4, p147 

    Cauda equina syndrome, that is the symptoms and signs of cauda equina compression, does not often present to the urological surgeon. However, when it does it may pose a major problem in diagnosis and management, simply because the average urological surgeon may never have seen the condition...

  • Haeger's sleep center helps dreams come true. Bentley, Ryan // Wenatchee Business Journal;Feb2008, Vol. 22 Issue 2, p12 

    The article features the Central Washington Sleep Diagnostic Center in Wenatchee, Washington. The sleep center is owned by Dr. Eric Haeger. The clinic on diagnosis and provides treatment for those afflicted with sleep apnea in which people stop breathing while in dreamland. Haeger estimates...

  • The limitations of evidence from randomised trials. Magder, Sheldon // CMAJ: Canadian Medical Association Journal;10/17/2000, Vol. 163 Issue 8, p986 

    Discusses a study of the use of noninvasive positive-pressure ventilation as opposed to endotracheal intubation on patients with severe respiratory distress. Outcome of the study which reported a higher death rate than randomized clinical trials; Possible reasons for the difference; Opinion...

  • Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial. Lewinson, Ryan T.; Wiley, J. Preston; Humble, R. Neil; Worobets, Jay T.; Stefanyshyn, Darren J. // PLoS ONE;7/31/2015, Vol. 10 Issue 7, p1 

    Objective: Determine if a change in internal knee abduction angular impulse (KAAI) is related to pain reduction for runners with patellofemoral pain (PFP) by comparing lateral and medial wedge insole interventions, and increased KAAI and decreased KAAI groups. Design: Randomized controlled...

  • Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians. Qaseem, Amir; Holty, Jon-Erik C.; Owens, Douglas K.; Dallas, Paul; Starkey, Melissa; Shekelle, Paul // Annals of Internal Medicine;10/1/2013, Vol. 159 Issue 7, Following p471 

    Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of obstructive sleep apnea (OSA) in adults. Methods: This guideline is based on published literature from 1966 to September 2010 that was...

  • Clinical features of hemorrhagic fever with renal syndrome in Korea. Jung Sang Lee // Kidney International Supplement;Dec1991, Issue 35, pS-88 

    Describes the clinical features in serologically proven cases of hemorrhagic fever with renal syndrome (HFRS) in Korea caused by hantaan virus. Diversity of the clinical features of HFRS; Discovery of variation in clinical pattern, duration and severity of manifestations; Comparison between...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics