Source validation of pancreatitis-related hospital discharge diagnoses notified to a national registry in the Netherlands.
BACKGROUND
National and regional disease registries are often used for epidemiological studies and validation analyses are scarce. We analyzed the reliability of the National Information System on Hospital Care (NISHC) registry used to classify admissions for acute and chronic pancreatitis in the Netherlands.


METHODS
All pancreas-related discharge diagnoses notified by the Academic Medical Center to the NISHC were retrieved for a 2-year time period. A review of multidisciplinary patient reports was conducted to verify these diagnoses.


RESULTS
284 patients were notified to the NISHC, relating to 483 admissions with 523 pancreas-related discharge diagnoses. Of these diagnoses, 112 were coded as acute pancreatitis, 250 as chronic pancreatitis and 161 were classified as pseudocysts and other pancreatic diseases. The positive predictive value for acute pancreatitis diagnosis codes was 77.7% and 46 additional acute pancreatitis diagnoses were identified, ultimately leading to an underestimation of the total number of acute pancreatitis diagnoses of 15.8%. The positive predictive value for discharge diagnoses regarding chronic pancreatitis was 83.6% and 57 additional chronic pancreatitis diagnoses were identified, finally resulting in an underestimation of the total number of chronic pancreatitis diagnoses of 6%.


CONCLUSIONS
There is a substantial miscoding on a person level of discharge diagnoses of acute and chronic pancreatitis. On a group level, when miscoding between categories is leveled out, actual numbers of admission are only slightly underestimated.
Spanier
B W M
BW
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. b.w.spanier@amc.uva.nl
Schreuder
D
D
Dijkgraaf
M G W
MG
Bruno
M J
MJ