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Nationwide validation study of diagnostic algorithms for inflammatory bowel disease in Korean National Health Insurance Service database

Authors
 Chang Kyun Lee  ;  Hyo Jung Ha  ;  Shin Ju Oh  ;  Jung-Wook Kim  ;  Jung Kuk Lee  ;  Hyun-Soo Kim  ;  Soon Man Yoon  ;  Sang-Bum Kang  ;  Eun Soo Kim  ;  Tae Oh Kim  ;  Soo-Young Na  ;  Jun Lee  ;  Sang-Wook Kim  ;  Hoon Sup Koo  ;  Byung Kyu Park  ;  Han Hee Lee  ;  Eun Sun Kim  ;  Jae Jun Park  ;  Min Seob Kwak  ;  Jae Myung Cha  ;  Byong Duk Ye  ;  Chang Hwan Choi  ;  Hyo Jong Kim 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.35(5) : 760-768, 2020-05 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2020-05
MeSH
Algorithms* ; Databases, Factual* ; Humans ; Inflammatory Bowel Diseases / diagnosis* ; Inflammatory Bowel Diseases / epidemiology ; International Classification of Diseases ; National Health Programs* ; Predictive Value of Tests ; Rare Diseases ; Registries ; Republic of Korea / epidemiology
Keywords
administrative claims ; health care ; diagnostic algorithm ; inflammatory bowel disease ; operational definition
Abstract
Background and Aim We conducted a nationwide validation study of diagnostic algorithms to identify cases of inflammatory bowel disease (IBD) within the Korea National Health Insurance System (NHIS) database. Method Using the NHIS dataset, we developed 44 algorithms combining the International Classification of Diseases (ICD)-10 codes, codes for Rare and Intractable Diseases (RID) registration and claims data for health care encounters, and pharmaceutical prescriptions for IBD-specific drugs. For each algorithm, we compared the case identification results from electronic medical records data with the gold standard (chart-based diagnosis). A multiple sampling test verified the validation results from the entire study population. Results A random nationwide sample of 1697 patients (848 potential cases and 849 negative control cases) from 17 hospitals were included for validation. A combination of the ICD-10 code, >= 1 claims for health care encounters, and >= 1 prescription claims (reference algorithm) achieved excellent performance (sensitivity, 93.1% [95% confidence interval 91-94.7]; specificity, 98.1% [96.9-98.8]; positive predictive value, 97.5% [96.1-98.5]; negative predictive value, 94.5% [92.8-95.8]) with the lowest error rate (4.2% [3.3-5.3]). The multiple sampling test confirmed that the reference algorithm achieves the best performance regarding IBD diagnosis. Algorithms including the RID registration codes exhibited poorer performance compared with that of the reference algorithm, particularly for the diagnosis of patients affiliated with secondary hospitals. The performance of the reference algorithm showed no statistical difference depending on the hospital volume or IBD type, with P-value < 0.05. Conclusions We strongly recommend the reference algorithm as a uniform standard operational definition for future studies using the NHIS database.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/jgh.14855
DOI
10.1111/jgh.14855
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jae Jun(박재준)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190104
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