title: A systematic review of validated methods for identifying venous thromboembolism using administrative and claims data.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a serious complication. Large claims databases can potentially identify the effects that medications have on VTE. The purpose of this study is to evaluate the evidence supporting the validity of VTE codes.
  
  
  METHODS
  A search of MEDLINE database is supplemented by manual searches of bibliographies of key relevant articles. We selected all studies in which a claim code was validated against a medical record. We reported the positive predictive value (PPV) for the VTE claim compared to the medical record.
  
  
  RESULTS
  Our search strategy yielded 345 studies, of which only 19 met our eligibility criteria. All of the studies reported on ICD-9 codes, but only two studies reported on pharmacy codes, and one study reported on procedure codes. The highest PPV (65%-95%) was reported for the combined use of ICD-9 codes 415 (pulmonary embolism), 451, and 453 (deep vein thrombosis) as a VTE event. If a specific event like DVT (PPV 24%-92%) or PE (PPV 31%-97%) was evaluated, the PPV was lower than when the combined events were examined. Studies that included patients after orthopedic surgery reported the highest PPV (96%-100%).
  
  
  CONCLUSIONS
  The use of ICD-9 415, 451, and 453 are appropriate for the identification of VTE in claims databases. The codes performed best when codes were evaluated in patients at higher risk of VTE.
authors.affiliation: Department of Medicine, Miller School of Medicine at the University of Miami, Miami, FL 33136, USA. ltamariz@med.miami.edu
authors.forename: Leonardo
authors.initials: L
authors.lastname: Tamariz
authors.forename: Thomas
authors.initials: T
authors.lastname: Harkins
authors.forename: Vinit
authors.initials: V
authors.lastname: Nair
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions; D015340:Epidemiologic Research Design; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D038801:International Classification of Diseases; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D054928:Validation Studies as Topic; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology