Accuracy of colorectal cancer ICD-9-CM codes in Italian administrative healthcare databases: A cross-sectional diagnostic study

Francesco Cozzolino, Ettore Bidoli, Iosief Abraha, Mario Fusco, Gianni Giovannini, Paola Casucci, Massimiliano Orso, Annalisa Granata, Marcello De Giorgi, Paolo Collarile, Valerio Ciullo, Maria Francesca Vitale, Roberto Cirocchi, Walter Orlandi, Diego Serraino, Alessandro Montedori

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives To assess the accuracy of International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes in identifying subjects with colorectal cancer. Design A diagnostic accuracy study comparing ICD-9-CM codes (index test) for colorectal cancers with medical chart (as a reference standard). Case ascertainment based on neoplastic lesion(s) within the colon/rectum and histological documentation from a primary or metastatic site positive for colorectal cancer. Setting Administrative databases from the Umbria region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) region and Friuli Venezia Giulia (FVG) region. Participants We randomly selected 130 incident patients from each hospital discharge database, admitted between 2012 and 2014, having colorectal cancer ICD-9 codes located in primary position, and 94 non-cases, that is, patients having a diagnosis of cancer (ICD-9 140-239) other than colorectal cancer in primary position. Outcome measures Sensitivity, specificity and predictive values for 153.x code (colon cancer) and for 154.x code (rectal cancer). Results The positive predictive value (PPV) for colon cancer diagnoses was 80% for Umbria (95% CI 73% to 87%), 81% for NA (95% CI 73% to 88%) and 80% for FVG (95% CI 72% to 87%). The sensitivity ranged from 98% to 99%, while the specificity ranged from 78% to 80% in the three units. For rectal cancer, the PPV was 84% for Umbria (95% CI 77% to 90%), 80% for NA (95% CI 72% to 87%) and 81% for FVG (95% CI 73% to 87%). The sensitivities ranged from 98% to 100%, while the specificity estimates from 79% to 82%. Conclusions Administrative databases in Italy can be a valuable tool for cancer surveillance as well as monitoring geographical and temporal variation of cancer practice.

Original languageEnglish
Article numbere020630
JournalBMJ Open
Volume8
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

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International Classification of Diseases
Colorectal Neoplasms
Cross-Sectional Studies
Databases
Delivery of Health Care
Rectal Neoplasms
Colonic Neoplasms
Neoplasms
Rectum
Documentation
Italy
Colon
Outcome Assessment (Health Care)
Sensitivity and Specificity

Keywords

  • Administrative Database
  • Colorectal Cancer
  • Icd-9-cm
  • Positive Predictive Value
  • Sensitivity And Specificity
  • Validity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Accuracy of colorectal cancer ICD-9-CM codes in Italian administrative healthcare databases : A cross-sectional diagnostic study. / Cozzolino, Francesco; Bidoli, Ettore; Abraha, Iosief; Fusco, Mario; Giovannini, Gianni; Casucci, Paola; Orso, Massimiliano; Granata, Annalisa; De Giorgi, Marcello; Collarile, Paolo; Ciullo, Valerio; Vitale, Maria Francesca; Cirocchi, Roberto; Orlandi, Walter; Serraino, Diego; Montedori, Alessandro.

In: BMJ Open, Vol. 8, No. 7, e020630, 01.07.2018.

Research output: Contribution to journalArticle

Cozzolino, F, Bidoli, E, Abraha, I, Fusco, M, Giovannini, G, Casucci, P, Orso, M, Granata, A, De Giorgi, M, Collarile, P, Ciullo, V, Vitale, MF, Cirocchi, R, Orlandi, W, Serraino, D & Montedori, A 2018, 'Accuracy of colorectal cancer ICD-9-CM codes in Italian administrative healthcare databases: A cross-sectional diagnostic study', BMJ Open, vol. 8, no. 7, e020630. https://doi.org/10.1136/bmjopen-2017-020630
Cozzolino, Francesco ; Bidoli, Ettore ; Abraha, Iosief ; Fusco, Mario ; Giovannini, Gianni ; Casucci, Paola ; Orso, Massimiliano ; Granata, Annalisa ; De Giorgi, Marcello ; Collarile, Paolo ; Ciullo, Valerio ; Vitale, Maria Francesca ; Cirocchi, Roberto ; Orlandi, Walter ; Serraino, Diego ; Montedori, Alessandro. / Accuracy of colorectal cancer ICD-9-CM codes in Italian administrative healthcare databases : A cross-sectional diagnostic study. In: BMJ Open. 2018 ; Vol. 8, No. 7.
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abstract = "Objectives To assess the accuracy of International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes in identifying subjects with colorectal cancer. Design A diagnostic accuracy study comparing ICD-9-CM codes (index test) for colorectal cancers with medical chart (as a reference standard). Case ascertainment based on neoplastic lesion(s) within the colon/rectum and histological documentation from a primary or metastatic site positive for colorectal cancer. Setting Administrative databases from the Umbria region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) region and Friuli Venezia Giulia (FVG) region. Participants We randomly selected 130 incident patients from each hospital discharge database, admitted between 2012 and 2014, having colorectal cancer ICD-9 codes located in primary position, and 94 non-cases, that is, patients having a diagnosis of cancer (ICD-9 140-239) other than colorectal cancer in primary position. Outcome measures Sensitivity, specificity and predictive values for 153.x code (colon cancer) and for 154.x code (rectal cancer). Results The positive predictive value (PPV) for colon cancer diagnoses was 80{\%} for Umbria (95{\%} CI 73{\%} to 87{\%}), 81{\%} for NA (95{\%} CI 73{\%} to 88{\%}) and 80{\%} for FVG (95{\%} CI 72{\%} to 87{\%}). The sensitivity ranged from 98{\%} to 99{\%}, while the specificity ranged from 78{\%} to 80{\%} in the three units. For rectal cancer, the PPV was 84{\%} for Umbria (95{\%} CI 77{\%} to 90{\%}), 80{\%} for NA (95{\%} CI 72{\%} to 87{\%}) and 81{\%} for FVG (95{\%} CI 73{\%} to 87{\%}). The sensitivities ranged from 98{\%} to 100{\%}, while the specificity estimates from 79{\%} to 82{\%}. Conclusions Administrative databases in Italy can be a valuable tool for cancer surveillance as well as monitoring geographical and temporal variation of cancer practice.",
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T2 - A cross-sectional diagnostic study

AU - Cozzolino, Francesco

AU - Bidoli, Ettore

AU - Abraha, Iosief

AU - Fusco, Mario

AU - Giovannini, Gianni

AU - Casucci, Paola

AU - Orso, Massimiliano

AU - Granata, Annalisa

AU - De Giorgi, Marcello

AU - Collarile, Paolo

AU - Ciullo, Valerio

AU - Vitale, Maria Francesca

AU - Cirocchi, Roberto

AU - Orlandi, Walter

AU - Serraino, Diego

AU - Montedori, Alessandro

PY - 2018/7/1

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N2 - Objectives To assess the accuracy of International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes in identifying subjects with colorectal cancer. Design A diagnostic accuracy study comparing ICD-9-CM codes (index test) for colorectal cancers with medical chart (as a reference standard). Case ascertainment based on neoplastic lesion(s) within the colon/rectum and histological documentation from a primary or metastatic site positive for colorectal cancer. Setting Administrative databases from the Umbria region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) region and Friuli Venezia Giulia (FVG) region. Participants We randomly selected 130 incident patients from each hospital discharge database, admitted between 2012 and 2014, having colorectal cancer ICD-9 codes located in primary position, and 94 non-cases, that is, patients having a diagnosis of cancer (ICD-9 140-239) other than colorectal cancer in primary position. Outcome measures Sensitivity, specificity and predictive values for 153.x code (colon cancer) and for 154.x code (rectal cancer). Results The positive predictive value (PPV) for colon cancer diagnoses was 80% for Umbria (95% CI 73% to 87%), 81% for NA (95% CI 73% to 88%) and 80% for FVG (95% CI 72% to 87%). The sensitivity ranged from 98% to 99%, while the specificity ranged from 78% to 80% in the three units. For rectal cancer, the PPV was 84% for Umbria (95% CI 77% to 90%), 80% for NA (95% CI 72% to 87%) and 81% for FVG (95% CI 73% to 87%). The sensitivities ranged from 98% to 100%, while the specificity estimates from 79% to 82%. Conclusions Administrative databases in Italy can be a valuable tool for cancer surveillance as well as monitoring geographical and temporal variation of cancer practice.

AB - Objectives To assess the accuracy of International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes in identifying subjects with colorectal cancer. Design A diagnostic accuracy study comparing ICD-9-CM codes (index test) for colorectal cancers with medical chart (as a reference standard). Case ascertainment based on neoplastic lesion(s) within the colon/rectum and histological documentation from a primary or metastatic site positive for colorectal cancer. Setting Administrative databases from the Umbria region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) region and Friuli Venezia Giulia (FVG) region. Participants We randomly selected 130 incident patients from each hospital discharge database, admitted between 2012 and 2014, having colorectal cancer ICD-9 codes located in primary position, and 94 non-cases, that is, patients having a diagnosis of cancer (ICD-9 140-239) other than colorectal cancer in primary position. Outcome measures Sensitivity, specificity and predictive values for 153.x code (colon cancer) and for 154.x code (rectal cancer). Results The positive predictive value (PPV) for colon cancer diagnoses was 80% for Umbria (95% CI 73% to 87%), 81% for NA (95% CI 73% to 88%) and 80% for FVG (95% CI 72% to 87%). The sensitivity ranged from 98% to 99%, while the specificity ranged from 78% to 80% in the three units. For rectal cancer, the PPV was 84% for Umbria (95% CI 77% to 90%), 80% for NA (95% CI 72% to 87%) and 81% for FVG (95% CI 73% to 87%). The sensitivities ranged from 98% to 100%, while the specificity estimates from 79% to 82%. Conclusions Administrative databases in Italy can be a valuable tool for cancer surveillance as well as monitoring geographical and temporal variation of cancer practice.

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KW - Positive Predictive Value

KW - Sensitivity And Specificity

KW - Validity

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