Sensitivity and specificity of breast cancer ICD-9-CM codes in three Italian administrative healthcare databases: A diagnostic accuracy study

The D.I.V.O. Group

Research output: Contribution to journalArticle

Abstract

Objectives: To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying patients diagnosed with incident carcinoma in situ and invasive breast cancer in three Italian administrative databases. Design: A diagnostic accuracy study comparing ICD-9-CM codes for carcinoma in situ (233.0) and for invasive breast cancer (174.x) with medical chart (as a reference standard). Case definition: (1) presence of a primary nodular lesion in the breast and (2) cytological or histological documentation of cancer from a primary or metastatic site. Setting: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli VeneziaGiulia (FVG) Region. Participants: Women with breast carcinoma in situ (n=246) or invasive breast cancer (n=384) diagnosed (in primary position) between 2012 and 2014. Outcome measures: Sensitivity and specificity for codes 233.0 and 174.x. Results: For invasive breast cancer the sensitivities were 98% (95% CI 93% to 99%) for Umbria, 96% (95% CI 91% to 99%) for NA and 100% (95% CI 97% to 100%) for FVG. Specificities were 90% (95% CI 82% to 95%) for Umbria, 91% (95% CI 83% to 96%) for NA and 91% (95% CI 84% to 96%) for FVG. For carcinoma in situ the sensitivities were 100% (95% CI 93% to 100%) for Umbria, 100% (95% CI 95% to 100%) for NA and 100% (95% CI 96% to 100%) for FVG. Specificities were 98% (95% CI 93% to 100%) for Umbria, 86% (95% CI 78% to 92%) for NA and 90% (95% CI 82% to 95%) for FVG. Conclusions: Administrative healthcare databases from Umbria, NA and FVG are accurate in identifying hospitalised news cases of carcinoma of the breast. The proposed case definition is a powerful tool to perform research on large populations of newly diagnosed patients with breast cancer.

Original languageEnglish
Article numbere020627
JournalBMJ Open
Volume8
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

Fingerprint

International Classification of Diseases
Databases
Breast Neoplasms
Delivery of Health Care
Sensitivity and Specificity
Carcinoma in Situ
Documentation
Breast
Outcome Assessment (Health Care)
Research
Population
Neoplasms

Keywords

  • administrative database
  • breast cancer
  • sensitivity and specificity
  • validity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sensitivity and specificity of breast cancer ICD-9-CM codes in three Italian administrative healthcare databases : A diagnostic accuracy study. / The D.I.V.O. Group.

In: BMJ Open, Vol. 8, No. 7, e020627, 01.07.2018.

Research output: Contribution to journalArticle

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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 patients diagnosed with incident carcinoma in situ and invasive breast cancer in three Italian administrative databases. Design: A diagnostic accuracy study comparing ICD-9-CM codes for carcinoma in situ (233.0) and for invasive breast cancer (174.x) with medical chart (as a reference standard). Case definition: (1) presence of a primary nodular lesion in the breast and (2) cytological or histological documentation of cancer from a primary or metastatic site. Setting: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli VeneziaGiulia (FVG) Region. Participants: Women with breast carcinoma in situ (n=246) or invasive breast cancer (n=384) diagnosed (in primary position) between 2012 and 2014. Outcome measures: Sensitivity and specificity for codes 233.0 and 174.x. Results: For invasive breast cancer the sensitivities were 98{\%} (95{\%} CI 93{\%} to 99{\%}) for Umbria, 96{\%} (95{\%} CI 91{\%} to 99{\%}) for NA and 100{\%} (95{\%} CI 97{\%} to 100{\%}) for FVG. Specificities were 90{\%} (95{\%} CI 82{\%} to 95{\%}) for Umbria, 91{\%} (95{\%} CI 83{\%} to 96{\%}) for NA and 91{\%} (95{\%} CI 84{\%} to 96{\%}) for FVG. For carcinoma in situ the sensitivities were 100{\%} (95{\%} CI 93{\%} to 100{\%}) for Umbria, 100{\%} (95{\%} CI 95{\%} to 100{\%}) for NA and 100{\%} (95{\%} CI 96{\%} to 100{\%}) for FVG. Specificities were 98{\%} (95{\%} CI 93{\%} to 100{\%}) for Umbria, 86{\%} (95{\%} CI 78{\%} to 92{\%}) for NA and 90{\%} (95{\%} CI 82{\%} to 95{\%}) for FVG. Conclusions: Administrative healthcare databases from Umbria, NA and FVG are accurate in identifying hospitalised news cases of carcinoma of the breast. The proposed case definition is a powerful tool to perform research on large populations of newly diagnosed patients with breast cancer.",
keywords = "administrative database, breast cancer, sensitivity and specificity, validity",
author = "{The D.I.V.O. Group} and Iosief Abraha and Diego Serraino and Alessandro Montedori and Mario Fusco and Gianni Giovannini and Paola Casucci and Francesco Cozzolino and Massimiliano Orso and Annalisa Granata and {De Giorgi}, Marcello and Paolo Collarile and Rita Chiari and Jennifer Foglietta and Vitale, {Maria Francesca} and Fabrizio Stracci and Walter Orlandi and Ettore Bidoli",
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T2 - A diagnostic accuracy study

AU - The D.I.V.O. Group

AU - Abraha, Iosief

AU - Serraino, Diego

AU - Montedori, Alessandro

AU - Fusco, Mario

AU - Giovannini, Gianni

AU - Casucci, Paola

AU - Cozzolino, Francesco

AU - Orso, Massimiliano

AU - Granata, Annalisa

AU - De Giorgi, Marcello

AU - Collarile, Paolo

AU - Chiari, Rita

AU - Foglietta, Jennifer

AU - Vitale, Maria Francesca

AU - Stracci, Fabrizio

AU - Orlandi, Walter

AU - Bidoli, Ettore

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Objectives: To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying patients diagnosed with incident carcinoma in situ and invasive breast cancer in three Italian administrative databases. Design: A diagnostic accuracy study comparing ICD-9-CM codes for carcinoma in situ (233.0) and for invasive breast cancer (174.x) with medical chart (as a reference standard). Case definition: (1) presence of a primary nodular lesion in the breast and (2) cytological or histological documentation of cancer from a primary or metastatic site. Setting: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli VeneziaGiulia (FVG) Region. Participants: Women with breast carcinoma in situ (n=246) or invasive breast cancer (n=384) diagnosed (in primary position) between 2012 and 2014. Outcome measures: Sensitivity and specificity for codes 233.0 and 174.x. Results: For invasive breast cancer the sensitivities were 98% (95% CI 93% to 99%) for Umbria, 96% (95% CI 91% to 99%) for NA and 100% (95% CI 97% to 100%) for FVG. Specificities were 90% (95% CI 82% to 95%) for Umbria, 91% (95% CI 83% to 96%) for NA and 91% (95% CI 84% to 96%) for FVG. For carcinoma in situ the sensitivities were 100% (95% CI 93% to 100%) for Umbria, 100% (95% CI 95% to 100%) for NA and 100% (95% CI 96% to 100%) for FVG. Specificities were 98% (95% CI 93% to 100%) for Umbria, 86% (95% CI 78% to 92%) for NA and 90% (95% CI 82% to 95%) for FVG. Conclusions: Administrative healthcare databases from Umbria, NA and FVG are accurate in identifying hospitalised news cases of carcinoma of the breast. The proposed case definition is a powerful tool to perform research on large populations of newly diagnosed patients with breast cancer.

AB - Objectives: To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying patients diagnosed with incident carcinoma in situ and invasive breast cancer in three Italian administrative databases. Design: A diagnostic accuracy study comparing ICD-9-CM codes for carcinoma in situ (233.0) and for invasive breast cancer (174.x) with medical chart (as a reference standard). Case definition: (1) presence of a primary nodular lesion in the breast and (2) cytological or histological documentation of cancer from a primary or metastatic site. Setting: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli VeneziaGiulia (FVG) Region. Participants: Women with breast carcinoma in situ (n=246) or invasive breast cancer (n=384) diagnosed (in primary position) between 2012 and 2014. Outcome measures: Sensitivity and specificity for codes 233.0 and 174.x. Results: For invasive breast cancer the sensitivities were 98% (95% CI 93% to 99%) for Umbria, 96% (95% CI 91% to 99%) for NA and 100% (95% CI 97% to 100%) for FVG. Specificities were 90% (95% CI 82% to 95%) for Umbria, 91% (95% CI 83% to 96%) for NA and 91% (95% CI 84% to 96%) for FVG. For carcinoma in situ the sensitivities were 100% (95% CI 93% to 100%) for Umbria, 100% (95% CI 95% to 100%) for NA and 100% (95% CI 96% to 100%) for FVG. Specificities were 98% (95% CI 93% to 100%) for Umbria, 86% (95% CI 78% to 92%) for NA and 90% (95% CI 82% to 95%) for FVG. Conclusions: Administrative healthcare databases from Umbria, NA and FVG are accurate in identifying hospitalised news cases of carcinoma of the breast. The proposed case definition is a powerful tool to perform research on large populations of newly diagnosed patients with breast cancer.

KW - administrative database

KW - breast cancer

KW - sensitivity and specificity

KW - validity

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DO - 10.1136/bmjopen-2017-020627

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