Diagnostic accuracy of common infectious disease discharge diagnoses from emergency department

INTRODUCTION: Discharge diagnoses in Danish medical records are transferred to health data registries and are often used for research. However, discharge diagnoses of common acute infections have not yet been validated. This study aimed to evaluate the diagnostic accuracy of discharge diagnoses in medical records related to general infectious conditions, including community-acquired pneumonia, urinary tract infections and skin and soft tissue infections, in a population of acutely admitted medical patients. METHODS: This was a multicentre retrospective diagnostic accuracy study including acutely admitted patients. Patients were eligible if the treating physician initially suspected an infectious condition. The diagnosis from the discharge letters was the index test. The reference standard was the final diagnosis determined by a medical expert panel. RESULTS: We included 954 patients. Positive predictive value, sensitivity and specificity (with 95% CI) were: 95% (93-96%); 84% (82-89%); 80% (77-82%) for any infection, 83% (80-85%); 77% (75-80%); 94% (92-95%) for community-acquired pneumonia, 87% (85-89%); 82% (80-85%); 97% (96-98%) for urinary tract infection, and 100% (100-100%); 90% (88-92%); 100% (100-100%) for skin and soft tissue infections. CONCLUSIONS: Our findings indicate that discharge diagnoses registered in the Danish National Patient Registry for the examined conditions should be used with caution for research purposes.None. TRIAL REGISTRATION: Not relevant.