title: Validating administrative records in post-traumatic stress disorder.
abstract: There is insufficient data on the accuracy of administrative coding data (ACD) for post-traumatic stress disorder (PTSD). Medical records were reviewed for (1) a diagnosis of PTSD; (2) treatment for PTSD. The records were compared against the Veterans Health Administration (VHA) data in order to determine the positive predictive value (PPV) and negative predictive value (NPV) of three commonly used approaches. The PPV and NPV varied according to the ACD approach. Relative to a medical records review, the ACD approach of one or two PTSD coded outpatient encounters had a PPV of 78% and an NPV of 91%; whereas the PPV was 97% and the NPV was 98% for three or more PTSD codes. For pharmacotherapy, the ACD approach with one or two codes for PTSD had a PPV of 33% (NPV = 93%), whereas three or more PTSD coded encounters improved the PPV to 85% (NPV = 100%). When using VHA data, we recommend tailoring the identification strategy according to the research aims. An ACD approach identifying one or more PTSD outpatient encounters should be considered sufficient for a diagnosis of PTSD. Assessments for PTSD associated pharmacotherapy require using an ACD approach that identifies veterans with the presence ≥ 3 outpatient PTSD encounters. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
authors.affiliation: Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.|Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Thad E
authors.initials: TE
authors.lastname: Abrams
authors.affiliation: Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.|Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Vaughan-Sarrazin
authors.affiliation: National Center for PTSD, Veterans Affairs Medical Center, Boston, MA, USA.|Boston University School of Medicine, Boston, MA, USA.
authors.forename: Terence M
authors.initials: TM
authors.lastname: Keane
authors.affiliation: Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Richardson
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data
keywords: PTSD; methodology; trauma