title: A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective.
abstract: Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims.
  
  
  
  A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015. The proportion of CRS ICD-9-coded claims (473.x and 471.x) for each of these 200 patients were reviewed and the validity of 7 different ICD-9-based coding algorithms was evaluated.
  
  
  
  The CRS case definition of ≥2 claims with a CRS ICD-9 code (471.x or 473.x) within 2 years of the reference case provides a balanced validity with a sensitivity of 77% and specificity of 79%. Applying this CRS case definition to the claims database produced a CRS cohort of 51,000 patients with characteristics that were consistent with published demographics and rates of comorbid asthma, allergic rhinitis, and depression.
  
  
  
  This study has validated several coding algorithms; based on the results a case definition of ≥2 physician claims of CRS (ICD-9 of 471.x or 473.x) within 2 years provides an optimal level of validity. Future studies will need to validate this administrative case definition from different health system perspectives and using larger retrospective chart reviews from multiple providers.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. lukerudmik@gmail.com.|Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. lukerudmik@gmail.com.
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Data Integration, Measurement and Reporting (DIMR), Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Edward
authors.initials: E
authors.lastname: Kukec
authors.affiliation: Data Integration, Measurement and Reporting (DIMR), Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Mingfu
authors.initials: M
authors.lastname: Liu
authors.affiliation: Data Integration, Measurement and Reporting (DIMR), Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Stafford
authors.initials: S
authors.lastname: Dean
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
mesh_terms: D000328:Adult; D002170:Canada; D002908:Chronic Disease; D059019:Clinical Coding / Q000592:standards*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D017891:Pharmacoepidemiology; D012220:Rhinitis / Q000175:diagnosis*; D012852:Sinusitis / Q000175:diagnosis*
keywords: ICD; administrative data; case definition; chronic sinusitis; epidemiology; rhinosinusitis; validation