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Cited 18 time in webofscience Cited 16 time in scopus
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Nationwide validation study of diagnostic algorithms for inflammatory bowel disease in Korean National Health Insurance Service database

Authors
Lee, Chang KyunHa, Hyo JungOh, Shin JuKim, Jung-WookLee, Jung KukKim, Hyun-SooYoon, Soon ManKang, Sang-BumKim, Eun SooKim, Tae OhNa, Soo-YoungLee, JunKim, Sang-WookKoo, Hoon SupPark, Byung KyuLee, Han HeeKim, Eun SunPark, Jae JunKwak, Min SeobCha, Jae MyungYe, Byong DukChoi, Chang HwanKim, Hyo Jong
Issue Date
May-2020
Publisher
WILEY
Keywords
administrative claims; health care; diagnostic algorithm; inflammatory bowel disease; operational definition
Citation
Journal of Gastroenterology and Hepatology, v.35, no.5, pp.760 - 768
Indexed
SCIE
SCOPUS
Journal Title
Journal of Gastroenterology and Hepatology
Volume
35
Number
5
Start Page
760
End Page
768
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28115
DOI
10.1111/jgh.14855
ISSN
0815-9319
Abstract
Background and Aim We conducted a nationwide validation study of diagnostic algorithms to identify cases of inflammatory bowel disease (IBD) within the Korea National Health Insurance System (NHIS) database. Method Using the NHIS dataset, we developed 44 algorithms combining the International Classification of Diseases (ICD)-10 codes, codes for Rare and Intractable Diseases (RID) registration and claims data for health care encounters, and pharmaceutical prescriptions for IBD-specific drugs. For each algorithm, we compared the case identification results from electronic medical records data with the gold standard (chart-based diagnosis). A multiple sampling test verified the validation results from the entire study population. Results A random nationwide sample of 1697 patients (848 potential cases and 849 negative control cases) from 17 hospitals were included for validation. A combination of the ICD-10 code, >= 1 claims for health care encounters, and >= 1 prescription claims (reference algorithm) achieved excellent performance (sensitivity, 93.1% [95% confidence interval 91-94.7]; specificity, 98.1% [96.9-98.8]; positive predictive value, 97.5% [96.1-98.5]; negative predictive value, 94.5% [92.8-95.8]) with the lowest error rate (4.2% [3.3-5.3]). The multiple sampling test confirmed that the reference algorithm achieves the best performance regarding IBD diagnosis. Algorithms including the RID registration codes exhibited poorer performance compared with that of the reference algorithm, particularly for the diagnosis of patients affiliated with secondary hospitals. The performance of the reference algorithm showed no statistical difference depending on the hospital volume or IBD type, with P-value < 0.05. Conclusions We strongly recommend the reference algorithm as a uniform standard operational definition for future studies using the NHIS database.
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Kim, Eun Sun
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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