title: Accuracy of the ICD-10 discharge diagnosis for syncope.
abstract: OBJECTIVE
  Administrative discharge codes are widely used in epidemiology, but the specificity and sensitivity of this coding is unknown and must be validated. We assessed the validity of the discharge diagnosis of syncope in administrative registers and reviewed the etiology of syncope after workup.
  
  
  RESULTS
  Two samples were investigated. One sample consisted of 5262 randomly selected medical patients. The other sample consisted of 750 patients admitted or seen in the emergency department (ED) for syncope (ICD-10: R55.9) in three hospitals in Denmark. All charts were reviewed for baseline characteristics and to confirm the presence/absence of syncope and to compare with the administrative coding. In a sample of 600 admitted patients 570 (95%) and of 150 patients from ED 140 (93%) had syncope representing the positive predictive values. Median age of the population was 69 years (IQR: ± 14). In the second sample of 5262 randomly selected medical patients, 75 (1.4%) had syncope, of which 47 were coded as R55.9 yielding a sensitivity of 62.7%, a negative predictive value of 99.5%, and a specificity of 99.9%.
  
  
  CONCLUSIONS
  ED and hospital discharge diagnostic coding for syncope has a positive predictive value of 95% and a sensitivity of 63%.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. mruwald@hotmail.com
authors.forename: Martin Huth
authors.initials: MH
authors.lastname: Ruwald
authors.forename: Morten Lock
authors.initials: ML
authors.lastname: Hansen
authors.forename: Morten
authors.initials: M
authors.lastname: Lamberts
authors.forename: Søren Lund
authors.initials: SL
authors.lastname: Kristensen
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
authors.forename: Anne-Marie Schjerning
authors.initials: AM
authors.lastname: Olsen
authors.forename: Stefan Bisgaard
authors.initials: SB
authors.lastname: Christensen
authors.forename: Michael
authors.initials: M
authors.lastname: Vinther
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Jim
authors.initials: J
authors.lastname: Hansen
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis* / Q000453:epidemiology*