1 research outputs found
How Well Do ICDâ9âCM Codes Predict True Congenital Heart Defects? A Centers for Disease Control and PreventionâBased Multisite Validation Project
Background The Centers for Disease Control and Prevention's Surveillance of Congenital Heart Defects Across the Lifespan project uses large clinical and administrative databases at sites throughout the United States to understand populationâbased congenital heart defect (CHD) epidemiology and outcomes. These individual databases are also relied upon for accurate coding of CHD to estimate population prevalence. Methods and Results This validation project assessed a sample of 774 cases from 4 surveillance sites to determine the positive predictive value (PPV) for identifying a true CHD case and classifying CHD anatomic group accurately based on 57 International Classification of Diseases, Ninth Revision, Clinical Modification (ICDâ9âCM) codes. Chiâsquare tests assessed differences in PPV by CHD severity and age. Overall, PPV was 76.36% (591/774 [95% CI, 73.20â79.31]) for all sites and all CHDârelated ICDâ9âCM codes. Of patients with a code for complex CHD, 89.85% (177/197 [95% CI, 84.76â93.69]) had CHD; corresponding PPV estimates were 86.73% (170/196 [95% CI, 81.17â91.15]) for shunt, 82.99% (161/194 [95% CI, 76.95â87.99]) for valve, and 44.39% (83/187 [95% CI, 84.76â93.69]) for âOtherâ CHD anatomic group (X2=142.16, P64âyears of age, (X2=4.23, P<0.0001). Conclusions While CHD ICDâ9âCM codes had acceptable PPV (86.54%) (508/587 [95% CI, 83.51â89.20]) for identifying whether a patient has CHD when excluding patients with ICDâ9âCM codes for âOtherâ CHD and code 745.5, further evaluation and algorithm development may help inform and improve accurate identification of CHD in data sets across the CHD ICDâ9âCM code groups