title: Validity of administrative data in recording sepsis: a systematic review.
abstract: BACKGROUND
  Administrative health data have been used to study sepsis in large population-based studies. The validity of these study findings depends largely on the quality of the administrative data source and the validity of the case definition used. We systematically reviewed the literature to assess the validity of case definitions of sepsis used with administrative data.
  
  
  METHODS
  Embase and MEDLINE were searched for published articles with International Classification of Diseases (ICD) coded data used to define sepsis. Abstracts and full-text articles were reviewed in duplicate. Data were abstracted from all eligible full-text articles, including ICD-9- and/or ICD-10-based case definitions, sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).
  
  
  RESULTS
  Of 2,317 individual studies identified, 12 full-text articles met all eligibility criteria. A total of 38 sepsis case definitions were tested, which included over 130 different ICD codes. The most common ICD-9 codes were 038.x, 790.7 and 995.92, and the most common ICD-10 codes were A40.x and A41.x. The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%. Other tests of diagnostic accuracy were reported only in some studies. Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.
  
  
  CONCLUSIONS
  The validity of administrative data in recording sepsis varied substantially across individual studies and ICD definitions. Our work may serve as a reference point for consensus towards an improved and harmonized ICD-coded definition of sepsis.
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. rjjolley@ucalgary.ca.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Jolley
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. kjlsawka@ucalgary.ca.
authors.forename: Keri Jo
authors.initials: KJ
authors.lastname: Sawka
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. dyergens@ucalgary.ca.
authors.forename: Dean W
authors.initials: DW
authors.lastname: Yergens
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. hquan@ucalgary.ca.|O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280, Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. hquan@ucalgary.ca.
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. nathalie.jette@albertahealthservices.ca.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Administration Office: Room 1195 - Foothills Hospital 1403 - 29 Street NW, T2N 2T9, Calgary, AB, Canada. nathalie.jette@albertahealthservices.ca.|O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280, Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. nathalie.jette@albertahealthservices.ca.|Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre Room 1A10, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada. nathalie.jette@albertahealthservices.ca.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jetté
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada. cdoig@ucalgary.ca.|Snyder Institute for Chronic Diseases, University of Calgary, HRIC 4AA08, 3280 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada. cdoig@ucalgary.ca.|Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre Room 1A10, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada. cdoig@ucalgary.ca.|Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, McCaig Tower Ground Floor, ICU Administration, 3134 Hospital Drive NW, T2N 5A1, Calgary, AB, Canada. cdoig@ucalgary.ca.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Doig
mesh_terms: D006801:Humans; D038801:International Classification of Diseases; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*