Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study

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 subjects with melanoma. DESIGN: A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. SETTING: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. PARTICIPANTS: 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. OUTCOME MEASURES: Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. RESULTS: The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG. CONCLUSIONS: The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma.

Original languageEnglish
Pages (from-to)e020631
JournalBMJ Open
Volume8
Issue number4
DOIs
Publication statusPublished - Apr 20 2018

Fingerprint

International Classification of Diseases
Melanoma
Databases
Delivery of Health Care
Skin
Sensitivity and Specificity
Scrotum
Hip
Lower Extremity
Outcome Assessment (Health Care)

Keywords

  • accuracy
  • administrative database
  • Icd-9-cm
  • melanoma
  • sensitivity and specificity
  • validity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{8cb81f0458494cad879fbcd4c2e2647a,
title = "Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study",
abstract = "OBJECTIVES: To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma. DESIGN: A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. SETTING: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. PARTICIPANTS: 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. OUTCOME MEASURES: Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. RESULTS: The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100{\%} (95{\%} CI 96{\%} to 100{\%}) for Umbria, 99{\%} (95{\%} CI 94{\%} to 100{\%}) for NA and 98{\%} (95{\%} CI 93{\%} to 100{\%}) for FVG. The specificities were 88{\%} (95{\%} CI 80{\%} to 93{\%}) for Umbria, 77{\%} (95{\%} CI 69{\%} to 85{\%}) for NA and 79{\%} (95{\%} CI 71{\%} to 86{\%}) for FVG. CONCLUSIONS: The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma.",
keywords = "accuracy, administrative database, Icd-9-cm, melanoma, sensitivity and specificity, validity",
author = "{D.I.V.O. Group} and Massimiliano Orso and Diego Serraino and Iosief Abraha and Mario Fusco and Gianni Giovannini and Paola Casucci and Francesco Cozzolino and Annalisa Granata and Michele Gobbato and Fabrizio Stracci and Valerio Ciullo and Vitale, {Maria Francesca} and Paolo Eusebi and Walter Orlandi and Alessandro Montedori and Ettore Bidoli",
year = "2018",
month = "4",
day = "20",
doi = "10.1136/bmjopen-2017-020631",
language = "English",
volume = "8",
pages = "e020631",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "4",

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TY - JOUR

T1 - Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases

T2 - a diagnostic accuracy study

AU - D.I.V.O. Group

AU - Orso, Massimiliano

AU - Serraino, Diego

AU - Abraha, Iosief

AU - Fusco, Mario

AU - Giovannini, Gianni

AU - Casucci, Paola

AU - Cozzolino, Francesco

AU - Granata, Annalisa

AU - Gobbato, Michele

AU - Stracci, Fabrizio

AU - Ciullo, Valerio

AU - Vitale, Maria Francesca

AU - Eusebi, Paolo

AU - Orlandi, Walter

AU - Montedori, Alessandro

AU - Bidoli, Ettore

PY - 2018/4/20

Y1 - 2018/4/20

N2 - OBJECTIVES: To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma. DESIGN: A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. SETTING: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. PARTICIPANTS: 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. OUTCOME MEASURES: Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. RESULTS: The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG. CONCLUSIONS: The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma.

AB - OBJECTIVES: To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma. DESIGN: A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. SETTING: Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. PARTICIPANTS: 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. OUTCOME MEASURES: Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. RESULTS: The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG. CONCLUSIONS: The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma.

KW - accuracy

KW - administrative database

KW - Icd-9-cm

KW - melanoma

KW - sensitivity and specificity

KW - validity

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U2 - 10.1136/bmjopen-2017-020631

DO - 10.1136/bmjopen-2017-020631

M3 - Article

VL - 8

SP - e020631

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 4

ER -