title: Clinical coding of prospectively identified paediatric adverse drug reactions--a retrospective review of patient records.
abstract: BACKGROUND
  National Health Service (NHS) hospitals in the UK use a system of coding for patient episodes. The coding system used is the International Classification of Disease (ICD-10). There are ICD-10 codes which may be associated with adverse drug reactions (ADRs) and there is a possibility of using these codes for ADR surveillance. This study aimed to determine whether ADRs prospectively identified in children admitted to a paediatric hospital were coded appropriately using ICD-10.
  
  
  METHODS
  The electronic admission abstract for each patient with at least one ADR was reviewed. A record was made of whether the ADR(s) had been coded using ICD-10.
  
  
  RESULTS
  Of 241 ADRs, 76 (31.5%) were coded using at least one ICD-10 ADR code. Of the oncology ADRs, 70/115 (61%) were coded using an ICD-10 ADR code compared with 6/126 (4.8%) non-oncology ADRs (difference in proportions 56%, 95% CI 46.2% to 65.8%; p < 0.001).
  
  
  CONCLUSIONS
  The majority of ADRs detected in a prospective study at a paediatric centre would not have been identified if the study had relied on ICD-10 codes as a single means of detection. Data derived from administrative healthcare databases are not reliable for identifying ADRs by themselves, but may complement other methods of detection.
authors.affiliation: Research & Development, Alder Hey Children's NHS Foundation Trust, Liverpool, UK. jennifer.bellis@alderhey.nhs.uk.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Bellis
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Kirkham
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Nunn
authors.forename: Munir
authors.initials: M
authors.lastname: Pirmohamed
mesh_terms: D002648:Child; D059019:Clinical Coding / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis*; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*