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Predictive value of clinical diagnostic codes for the CDC case definition of pelvic inflammatory disease (PID): implications for surveillance.
Sexually Transmitted Diseases 2003;30(11):866-870.
Ratelle S, Yokoe D, Blejan C, Whelan M, Tang Y, Platt R, Blair R, Tao
G, Irwin KL.
Abstract
BACKGROUND: Reporting of pelvic inflammatory disease (PID) from private providers
could be incomplete because of time and staff constraints, lack of knowledge
of reporting requirements and of case definitions. Reporting burden can be
alleviated with the use of administrative data. GOAL: The goal of this study
was to determine the validity of clinical diagnostic codes assigned in electronic
medical records (EMR) for identifying PID and their use in enhancing surveillance.
STUDY DESIGN: A random sample of 296 records with a PID International Classification
of Diseases, 9th Revision (ICD-9), code (614.9) were reviewed to assess for
the presence of the Centers for Disease Control and Prevention (CDC) criteria
for the case definition of PID. We used the records meeting the CDC clinical
case definition criteria as the reference standard to determine the sensitivity,
specificity, and predictive values of various data elements. RESULTS: Used
alone, the positive predictive value (PPV) of ICD-9 code 614.9 for a CDC
case definition of PID was 18.1%. The PPV increased to 100% and 56% when
the ICD-9 code visit was associated with a positive test for Neisseria gonorrhoeae
(GC) and Chlamydia trachomatis (CT), respectively. CONCLUSION: In this multispecialty
group practice, a positive test for GC and CT coupled with ICD-9 code 614.9
could be used to enhance reporting of cases of PID.