title: Utility of International Classification of Diseases, Ninth Revision, Clinical Modification codes for communicable disease surveillance.
abstract: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes have been proposed as a method of public health surveillance and are widely used in public health and clinical research. However, ICD-9-CM codes have been found to have variable accuracy for both health-care billing and disease classification, and they have never been comprehensively validated for use in public health surveillance. Therefore, the authors undertook a comprehensive analysis of the positive predictive values (PPVs) of ICD-9-CM codes for communicable diseases in 6 North Carolina health-care systems for the year 2003. Stratified random samples of patient charts with ICD-9-CM diagnoses for communicable diseases were reviewed and evaluated for their concordance with the Centers for Disease Control and Prevention surveillance case definitions. Semi-Bayesian hierarchical regression techniques were employed on the ensemble of disease-specific PPVs in order to reduce the overall mean squared error. The authors found that for the majority for diseases with higher incidence and straightforward laboratory-based diagnoses, the PPVs were high (>80%), with the important exception of tuberculosis, which had a PPV of 28.6% (95% uncertainty interval: 15.6, 46.5).
authors.affiliation: Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina 27514, USA. esickber@unch.unc.edu
authors.forename: Emily E
authors.initials: EE
authors.lastname: Sickbert-Bennett
authors.forename: David J
authors.initials: DJ
authors.lastname: Weber
authors.forename: Charles
authors.initials: C
authors.lastname: Poole
authors.forename: Pia D M
authors.initials: PD
authors.lastname: MacDonald
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Maillard
mesh_terms: D003141:Communicable Diseases / Q000145:classification* / Q000453:epidemiology*; D016208:Databases, Factual / Q000592:standards; D006801:Humans; D038801:International Classification of Diseases / Q000592:standards* / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D015203:Reproducibility of Results