Publication: Value of the international classification of diseases code for identifying children with biliary atresia
Issued Date
2021-02-01
Resource Type
ISSN
20927258
17381061
17381061
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2-s2.0-85101460809
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Mahidol University
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SCOPUS
Bibliographic Citation
Korean Journal of Pediatrics. Vol.64, No.2 (2021), 80-85
Suggested Citation
Pornthep Tanpowpong, Chatmanee Lertudomphonwanit, Pornpimon Phuapradit, Suporn Treepongkaruna Value of the international classification of diseases code for identifying children with biliary atresia. Korean Journal of Pediatrics. Vol.64, No.2 (2021), 80-85. doi:10.3345/cep.2020.00423 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78461
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Title
Value of the international classification of diseases code for identifying children with biliary atresia
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Abstract
Background: Although identifying cases in large administrative databases may aid future research studies, previous reports demonstrated that the use of the International Classification of Diseases, Tenth Revision (ICD-10) code alone for diagnosis leads to disease misclassification. Purpose: We aimed to assess the value of the ICD-10 diagnostic code for identifying potential children with biliary atresia. Methods: Patients aged <18 years assigned the ICD-10 code of biliary atresia (Q44.2) between January 1996 and December 2016 at a quaternary care teaching hospital were identified. We also reviewed patients with other diagnoses of code-defined cirrhosis to identify more potential cases of biliary atresia. A proposed diagnostic algorithm was used to define ICD-10 code accuracy, sensitivity, and specificity. Results: We reviewed the medical records of 155 patients with ICD-10 code Q44.2 and 69 patients with other codes for biliary cirrhosis (K74.4, K74.5, K74.6). The accuracy for identifying definite/probable/possible biliary atresia cases was 80%, while the sensitivity was 88% (95% confidence inter-val [CI], 82%–93%). Three independent predictors were associated with algorithm-defined definite/probable/possible cases of biliary atresia: ICD-10 code Q44.2 (odds ratio [OR], 2.90; 95% CI, 1.09–7.71), history of pale stool (OR, 2.78; 95% CI, 1.18–6.60), and a presumed diagnosis of biliary atresia prior to referral to our hospital (OR, 17.49; 95% CI, 7.01–43.64). A significant interaction was noted between ICD-10 code Q44.2 and a history of pale stool (P<0.05). The area under the curve was 0.87 (95% CI, 0.84–0.89). Conclusion: ICD-10 code Q44.2 has an acceptable value for diagnosing biliary atresia. Incorporating clinical data improves the case identification. The use of this proposed diagnostic algorithm to examine data from administrative databases may facilitate appropriate health care allocation and aid future research investigations.