title: Adverse drug reactions in patients admitted to hospital identified by discharge ICD-10 codes and by spontaneous reports.
abstract: OBJECTIVE
  We studied the international classification of disease (ICD) hospital discharge codes to find unreported adverse drug reactions (ADRs), and asked doctors about their attitudes to reporting some of these cases.
  
  
  METHODS
  We examined the ICD codes assigned on discharge to identify ADRs and compared these with spontaneous reports made to the Committee on Safety of Medicines (CSM). Doctors involved were sent brief résumés of cases and asked if they would report them.
  
  
  RESULTS
  49 of 21 365 patient episodes were coded on discharge as ADRs, of which 33 were 'reportable'. Fourteen spontaneous reports were received by the CSM during the same period. The two groups did not overlap. 25 of 60 doctors responded to our questionnaire, and would have reported only 8 of 75 cases outlined.
  
  
  CONCLUSIONS
  The ICD coding allowed us to identify important ADRs which most doctors would not report spontaneously.
authors.affiliation: West Midlands Centre for Adverse Drug Reaction Reporting, City Hospital NHS Trust Birmingham, B18 7QH, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Cox
authors.forename: C
authors.initials: C
authors.lastname: Anton
authors.forename: C H
authors.initials: CH
authors.lastname: Goh
authors.forename: M
authors.initials: M
authors.lastname: Easter
authors.forename: N J
authors.initials: NJ
authors.lastname: Langford
authors.forename: R E
authors.initials: RE
authors.lastname: Ferner
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans