title: Validity of physician billing claims to identify deceased organ donors in large healthcare databases.
abstract: OBJECTIVE
  We evaluated the validity of physician billing claims to identify deceased organ donors in large provincial healthcare databases.
  
  
  METHODS
  We conducted a population-based retrospective validation study of all deceased donors in Ontario, Canada from 2006 to 2011 (n = 988). We included all registered deaths during the same period (n = 458,074). Our main outcome measures included sensitivity, specificity, positive predictive value, and negative predictive value of various algorithms consisting of physician billing claims to identify deceased organ donors and organ-specific donors compared to a reference standard of medical chart abstraction.
  
  
  RESULTS
  The best performing algorithm consisted of any one of 10 different physician billing claims. This algorithm had a sensitivity of 75.4% (95% CI: 72.6% to 78.0%) and a positive predictive value of 77.4% (95% CI: 74.7% to 80.0%) for the identification of deceased organ donors. As expected, specificity and negative predictive value were near 100%. The number of organ donors identified by the algorithm each year was similar to the expected value, and this included the pre-validation period (1991 to 2005). Algorithms to identify organ-specific donors performed poorly (e.g. sensitivity ranged from 0% for small intestine to 67% for heart; positive predictive values ranged from 0% for small intestine to 37% for heart).
  
  
  CONCLUSIONS
  Primary data abstraction to identify deceased organ donors should be used whenever possible, particularly for the detection of organ-specific donations. The limitations of physician billing claims should be considered whenever they are used.
authors: Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.
authors: Alvin Ho-ting
authors: AH
authors: Li
authors: S Joseph
authors: SJ
authors: Kim
authors: Jagadish
authors: J
authors: Rangrej
authors: Damon C
authors: DC
authors: Scales
authors: Salimah
authors: S
authors: Shariff
authors: Donald A
authors: DA
authors: Redelmeier
authors: Greg
authors: G
authors: Knoll
authors: Ann
authors: A
authors: Young
authors: Amit X
authors: AX
authors: Garg
mesh_terms: D000465:Algorithms; D016208:Databases, Factual; D003695:Delivery of Health Care; D006801:Humans; D008490:Medical Informatics / Q000379:methods*; D010820:Physicians / Q000191:economics*; D011050:Policy Making; D015203:Reproducibility of Results; D014019:Tissue Donors / Q000600:supply & distribution*
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