title: Administrative data sets are inaccurate for assessing functional outcomes after radical prostatectomy.
abstract: OBJECTIVE
  A recent report examined rates of urinary incontinence and erectile dysfunction following radical prostatectomy by evaluating administrative claims data. However, the validity of this approach for reporting functional outcomes has not been established. Therefore, we determined the prognostic value of administrative claims data for reporting urinary incontinence and erectile dysfunction after radical prostatectomy.
  
  
  METHODS
  We identified 562 patients who underwent radical prostatectomy from 2004 to 2007 and were followed at our institution with self-reported standardized survey data available at least 1 year after surgery. Urinary incontinence was assessed by self-reported pad use and the urinary function domain of the Expanded Prostate Cancer Index. Erectile dysfunction was assessed with the International Index of Erectile Function. These results were then compared with administrative claims data using ICD-9 and Hospital International Classification of Diseases Adapted codes for urinary incontinence and erectile dysfunction.
  
  
  RESULTS
  Administrative claims data demonstrated a poor correlation with patient self-reported questionnaire data. The administrative identification of erectile dysfunction was associated with a sensitivity of 0.598 and a specificity of 0.591. Poor correlation was also illustrated by the low kappa correlation coefficient of 0.184. Similarly urinary incontinence was poorly correlated with self-reported pad use and the urinary function domain of the Expanded Prostate Cancer Index (correlation coefficient 0.195).
  
  
  CONCLUSIONS
  Administrative claims data correlate poorly with validated questionnaire data when assessing functional outcomes after radical prostatectomy such as urinary incontinence and erectile dysfunction. Therefore, outcomes data generated using this approach may not reflect the development or severity of such complications.
authors.affiliation: Department of Urology, Mayo Medical School and Mayo Clinic, Rochester, Minnesota 55905, USA. tollefson.matthew@mayo.edu
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.forename: Igor
authors.initials: I
authors.lastname: Frank
mesh_terms: D019992:Databases as Topic; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D018426:SEER Program; D012680:Sensitivity and Specificity; D014549:Urinary Incontinence / Q000453:epidemiology*