title: The accuracy of burn diagnosis codes in health administrative data: A validation study.
abstract: BACKGROUND
  Health administrative databases may provide rich sources of data for the study of outcomes following burn. We aimed to determine the accuracy of International Classification of Diseases diagnoses codes for burn in a population-based administrative database.
  
  
  METHODS
  Data from a regional burn center's clinical registry of patients admitted between 2006-2013 were linked to administrative databases. Burn total body surface area (TBSA), depth, mechanism, and inhalation injury were compared between the registry and administrative records. The sensitivity, specificity, and positive and negative predictive values were determined, and coding agreement was assessed with the kappa statistic.
  
  
  RESULTS
  1215 burn center patients were linked to administrative records. TBSA codes were highly sensitive and specific for ≥10 and ≥20% TBSA (89/93% sensitive and 95/97% specific), with excellent agreement (κ, 0.85/κ, 0.88). Codes were weakly sensitive (68%) in identifying ≥10% TBSA full-thickness burn, though highly specific (86%) with moderate agreement (κ, 0.46). Codes for inhalation injury had limited sensitivity (43%) but high specificity (99%) with moderate agreement (κ, 0.54). Burn mechanism had excellent coding agreement (κ, 0.84).
  
  
  CONCLUSIONS
  Administrative data diagnosis codes accurately identify burn by burn size and mechanism, while identification of inhalation injury or full-thickness burns is less sensitive but highly specific.
authors.affiliation: Sunnybrook Research Institute, Toronto, Canada; Division of General Surgery, Department of General Surgery, University of Toronto, Toronto, Canada; Institute for Health Policy, Evaluation, and Management, University of Toronto, Toronto, Canada. Electronic address: stephanie.mason@mail.utoronto.ca.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Mason
authors.affiliation: Sunnybrook Research Institute, Toronto, Canada; Division of General Surgery, Department of General Surgery, University of Toronto, Toronto, Canada; Institute for Health Policy, Evaluation, and Management, University of Toronto, Toronto, Canada.
authors.forename: Avery B
authors.initials: AB
authors.lastname: Nathens
authors.affiliation: Sunnybrook Research Institute, Toronto, Canada; Division of General Surgery, Department of General Surgery, University of Toronto, Toronto, Canada; Institute for Health Policy, Evaluation, and Management, University of Toronto, Toronto, Canada.
authors.forename: James P
authors.initials: JP
authors.lastname: Byrne
authors.affiliation: Sunnybrook Research Institute, Toronto, Canada; Institute for Health Policy, Evaluation, and Management, University of Toronto, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada.
authors.forename: Rob
authors.initials: R
authors.lastname: Fowler
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: Sunnybrook Research Institute, Toronto, Canada; Division of General Surgery, Department of General Surgery, University of Toronto, Toronto, Canada; Institute for Health Policy, Evaluation, and Management, University of Toronto, Toronto, Canada.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Karanicolas
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.affiliation: Sunnybrook Research Institute, Toronto, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Canada.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jeschke
mesh_terms: D000328:Adult; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns / Q000175:diagnosis*; D002058:Burns, Electric / Q000175:diagnosis; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012042:Registries; D015208:Smoke Inhalation Injury / Q000175:diagnosis*
keywords: Administrative data; Burn; Burns; Validation