title: Specifying ICD9, ICPC and ATC codes for the STOPP/START criteria: a multidisciplinary consensus panel.
abstract: BACKGROUND
  the STOPP/START criteria are a promising framework to increase appropriate prescribing in the elderly in clinical practice. However, the current definitions of the STOPP/START criteria are rather non-specific, allowing undesirable variations in interpretation and thus application. The aim of this study was to design specifications of the STOPP/START criteria into international disease and medication codes to facilitate computerised extraction from medical records and databases.
  
  
  METHODS
  a three round consensus procedure with a multidisciplinary expert panel was organised to prepare, judge and agree on the design of the STOPP/START criteria specifications in corresponding international disease codes (ICD9 and ICPC) and medication codes (ATC).
  
  
  RESULTS
  after two rounds consensus was reached for 74% of the STOPP criteria and for 73% of the START criteria. After three rounds full consensus was reached resulting in a specification of 61 out of 62 STOPP criteria and 26 START criteria with their corresponding codes. One criterion could not be specified and for some criteria corresponding disease codes were lacking or imperfect.
  
  
  CONCLUSIONS
  this study showed the necessity of a consensus procedure as even experts frequently differed on how to specify the STOPP/START criteria. This specification enables next steps such as prognostic validation of these criteria on adverse outcomes and studying the impact of improving appropriate prescribing in the elderly.
authors: Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors: Dominique A
authors: DA
authors: de Groot
authors: Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors: Marloes
authors: M
authors: de Vries
authors: Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors: Karlijn J
authors: KJ
authors: Joling
authors: Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, the Netherlands.
authors: Jos P C M
authors: JP
authors: van Campen
authors: Department of Clinical Pharmacology and Pharmacy, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors: Jacqueline G
authors: JG
authors: Hugtenburg
authors: Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands Department of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
authors: Rob J
authors: RJ
authors: van Marum
authors: ZANOB, 's- Hertogenbosch, the Netherlands.
authors: Annemieke M A
authors: AM
authors: Vermeulen Windsant-van den Tweel
authors: Department of General Practice, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors: Petra J M
authors: PJ
authors: Elders
authors: Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors: Hein P
authors: HP
authors: van Hout
mesh_terms: D000367:Age Factors; D057189:Checklist; D016208:Databases, Factual; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000517:prevention & control*; D019983:Guideline Adherence; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D033183:Interdisciplinary Communication; D038801:International Classification of Diseases; D004364:Pharmaceutical Preparations / Q000145:classification* / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011320:Primary Health Care / Q000145:classification* / Q000592:standards; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires / Q000592:standards*; D009626:Terminology as Topic
chemical_list: D004364:Pharmaceutical Preparations
keywords: STOPP/START criteria; computerised extraction; inappropriate prescribing; older people; specification