Intracerebral hemorrhage: positive predictive value of diagnosis codes in two nationwide Danish registries

Stine Munk Hald, Christine Kring Sloth, Sabine Morris Hey, Charlotte Madsen, Nina Nguyen, Luis Alberto García Rodríguez, Rustam Al-Shahi Salman, Sören Möller, Frantz Rom Poulsen, Anton Pottegård, David Gaist

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Abstract

Purpose: The purpose of this study is to establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR).

Patients and methods: We estimated the positive predictive value (PPV) of ICH diagnoses for a sample of 500 patients from the DSR (patients recorded under ICH diagnosis) and DNPR (International Classification of Diseases, version 10, code I61) during 2010-2015, using discharge summaries and brain imaging reports (minimal data). We estimated PPVs for any ICH (a-ICH) and spontaneous ICH (s-ICH) alone. Furthermore, we assessed PPVs according to whether patients were recorded in both or only one of the registries. Finally, in a subsample with ICH diagnoses with access to full medical records and original imaging studies (extensive data, n=100), we compared s-ICH diagnosis and hemorrhage location after use of extensive vs minimal data.

Results: In the DSR, the PPVs were 94% (95% CI, 91%-96%) for a-ICH and 85% (95% CI, 81%-88%) for s-ICH. In the DNPR, the PPVs were 88% (95% CI, 84%-91%) for a-ICH and 75% (95% CI, 70%-79%) for s-ICH. PPVs for s-ICH for patients recorded in both registries, DSR only, and DNPR only were 86% (95% CI, 82-99), 80% (95%CI, 71-87), and 49% (95%CI, 39-59), respectively. Evaluation of extensive vs minimal data verified s-ICH diagnosis in 98% and hemorrhage location in 94%.

Conclusion: The validity of a-ICH diagnoses in DSR and DNPR is sufficiently high to support their use in epidemiologic studies. For s-ICH, validity was high in DSR. In DNPR, s-ICH validity was lower, markedly so for the small subgroup of patients only recorded in this registry. Minimal data including discharge summaries and brain imaging reports were feasible and valid for identifying ICH location.

Original languageEnglish
JournalClinical Epidemiology
Volume10
Pages (from-to)941-948
ISSN1179-1349
DOIs
Publication statusPublished - 1. Jan 2018

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Registries
Neuroimaging
International Classification of Diseases
Medical Records
Epidemiologic Studies

Keywords

  • Epidemiology
  • Intracranial hemorrhage
  • Register-based research
  • Stroke

Cite this

Hald, Stine Munk ; Kring Sloth, Christine ; Hey, Sabine Morris ; Madsen, Charlotte ; Nguyen, Nina ; García Rodríguez, Luis Alberto ; Al-Shahi Salman, Rustam ; Möller, Sören ; Poulsen, Frantz Rom ; Pottegård, Anton ; Gaist, David. / Intracerebral hemorrhage : positive predictive value of diagnosis codes in two nationwide Danish registries. In: Clinical Epidemiology. 2018 ; Vol. 10. pp. 941-948.
@article{050102cb56434daca8c7d6679f0ce6c5,
title = "Intracerebral hemorrhage: positive predictive value of diagnosis codes in two nationwide Danish registries",
abstract = "Purpose: The purpose of this study is to establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR).Patients and methods: We estimated the positive predictive value (PPV) of ICH diagnoses for a sample of 500 patients from the DSR (patients recorded under ICH diagnosis) and DNPR (International Classification of Diseases, version 10, code I61) during 2010-2015, using discharge summaries and brain imaging reports (minimal data). We estimated PPVs for any ICH (a-ICH) and spontaneous ICH (s-ICH) alone. Furthermore, we assessed PPVs according to whether patients were recorded in both or only one of the registries. Finally, in a subsample with ICH diagnoses with access to full medical records and original imaging studies (extensive data, n=100), we compared s-ICH diagnosis and hemorrhage location after use of extensive vs minimal data.Results: In the DSR, the PPVs were 94{\%} (95{\%} CI, 91{\%}-96{\%}) for a-ICH and 85{\%} (95{\%} CI, 81{\%}-88{\%}) for s-ICH. In the DNPR, the PPVs were 88{\%} (95{\%} CI, 84{\%}-91{\%}) for a-ICH and 75{\%} (95{\%} CI, 70{\%}-79{\%}) for s-ICH. PPVs for s-ICH for patients recorded in both registries, DSR only, and DNPR only were 86{\%} (95{\%} CI, 82-99), 80{\%} (95{\%}CI, 71-87), and 49{\%} (95{\%}CI, 39-59), respectively. Evaluation of extensive vs minimal data verified s-ICH diagnosis in 98{\%} and hemorrhage location in 94{\%}.Conclusion: The validity of a-ICH diagnoses in DSR and DNPR is sufficiently high to support their use in epidemiologic studies. For s-ICH, validity was high in DSR. In DNPR, s-ICH validity was lower, markedly so for the small subgroup of patients only recorded in this registry. Minimal data including discharge summaries and brain imaging reports were feasible and valid for identifying ICH location.",
keywords = "Epidemiology, Intracranial hemorrhage, Register-based research, Stroke",
author = "Hald, {Stine Munk} and {Kring Sloth}, Christine and Hey, {Sabine Morris} and Charlotte Madsen and Nina Nguyen and {Garc{\'i}a Rodr{\'i}guez}, {Luis Alberto} and {Al-Shahi Salman}, Rustam and S{\"o}ren M{\"o}ller and Poulsen, {Frantz Rom} and Anton Potteg{\aa}rd and David Gaist",
year = "2018",
month = "1",
day = "1",
doi = "10.2147/CLEP.S167576",
language = "English",
volume = "10",
pages = "941--948",
journal = "Clinical Epidemiology",
issn = "1179-1349",
publisher = "Dove Medical Press Ltd.(Dovepress)",

}

Intracerebral hemorrhage : positive predictive value of diagnosis codes in two nationwide Danish registries. / Hald, Stine Munk; Kring Sloth, Christine; Hey, Sabine Morris; Madsen, Charlotte; Nguyen, Nina; García Rodríguez, Luis Alberto; Al-Shahi Salman, Rustam; Möller, Sören; Poulsen, Frantz Rom; Pottegård, Anton; Gaist, David.

In: Clinical Epidemiology, Vol. 10, 01.01.2018, p. 941-948.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Intracerebral hemorrhage

T2 - positive predictive value of diagnosis codes in two nationwide Danish registries

AU - Hald, Stine Munk

AU - Kring Sloth, Christine

AU - Hey, Sabine Morris

AU - Madsen, Charlotte

AU - Nguyen, Nina

AU - García Rodríguez, Luis Alberto

AU - Al-Shahi Salman, Rustam

AU - Möller, Sören

AU - Poulsen, Frantz Rom

AU - Pottegård, Anton

AU - Gaist, David

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: The purpose of this study is to establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR).Patients and methods: We estimated the positive predictive value (PPV) of ICH diagnoses for a sample of 500 patients from the DSR (patients recorded under ICH diagnosis) and DNPR (International Classification of Diseases, version 10, code I61) during 2010-2015, using discharge summaries and brain imaging reports (minimal data). We estimated PPVs for any ICH (a-ICH) and spontaneous ICH (s-ICH) alone. Furthermore, we assessed PPVs according to whether patients were recorded in both or only one of the registries. Finally, in a subsample with ICH diagnoses with access to full medical records and original imaging studies (extensive data, n=100), we compared s-ICH diagnosis and hemorrhage location after use of extensive vs minimal data.Results: In the DSR, the PPVs were 94% (95% CI, 91%-96%) for a-ICH and 85% (95% CI, 81%-88%) for s-ICH. In the DNPR, the PPVs were 88% (95% CI, 84%-91%) for a-ICH and 75% (95% CI, 70%-79%) for s-ICH. PPVs for s-ICH for patients recorded in both registries, DSR only, and DNPR only were 86% (95% CI, 82-99), 80% (95%CI, 71-87), and 49% (95%CI, 39-59), respectively. Evaluation of extensive vs minimal data verified s-ICH diagnosis in 98% and hemorrhage location in 94%.Conclusion: The validity of a-ICH diagnoses in DSR and DNPR is sufficiently high to support their use in epidemiologic studies. For s-ICH, validity was high in DSR. In DNPR, s-ICH validity was lower, markedly so for the small subgroup of patients only recorded in this registry. Minimal data including discharge summaries and brain imaging reports were feasible and valid for identifying ICH location.

AB - Purpose: The purpose of this study is to establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR).Patients and methods: We estimated the positive predictive value (PPV) of ICH diagnoses for a sample of 500 patients from the DSR (patients recorded under ICH diagnosis) and DNPR (International Classification of Diseases, version 10, code I61) during 2010-2015, using discharge summaries and brain imaging reports (minimal data). We estimated PPVs for any ICH (a-ICH) and spontaneous ICH (s-ICH) alone. Furthermore, we assessed PPVs according to whether patients were recorded in both or only one of the registries. Finally, in a subsample with ICH diagnoses with access to full medical records and original imaging studies (extensive data, n=100), we compared s-ICH diagnosis and hemorrhage location after use of extensive vs minimal data.Results: In the DSR, the PPVs were 94% (95% CI, 91%-96%) for a-ICH and 85% (95% CI, 81%-88%) for s-ICH. In the DNPR, the PPVs were 88% (95% CI, 84%-91%) for a-ICH and 75% (95% CI, 70%-79%) for s-ICH. PPVs for s-ICH for patients recorded in both registries, DSR only, and DNPR only were 86% (95% CI, 82-99), 80% (95%CI, 71-87), and 49% (95%CI, 39-59), respectively. Evaluation of extensive vs minimal data verified s-ICH diagnosis in 98% and hemorrhage location in 94%.Conclusion: The validity of a-ICH diagnoses in DSR and DNPR is sufficiently high to support their use in epidemiologic studies. For s-ICH, validity was high in DSR. In DNPR, s-ICH validity was lower, markedly so for the small subgroup of patients only recorded in this registry. Minimal data including discharge summaries and brain imaging reports were feasible and valid for identifying ICH location.

KW - Epidemiology

KW - Intracranial hemorrhage

KW - Register-based research

KW - Stroke

U2 - 10.2147/CLEP.S167576

DO - 10.2147/CLEP.S167576

M3 - Journal article

C2 - 30123006

VL - 10

SP - 941

EP - 948

JO - Clinical Epidemiology

JF - Clinical Epidemiology

SN - 1179-1349

ER -