Ascertainment of colonoscopy indication using administrative data

Dig Dis Sci. 2010 Jun;55(6):1721-5. doi: 10.1007/s10620-010-1200-y.


Background: Administrative procedure code data can estimate colonoscopy utilization; however, determining colonoscopy indication is more difficult as procedure codes do not inherently reflect the purpose (screening, surveillance, diagnosis) of the colonoscopy.

Aim: To improve the reported sensitivity (70%) and specificity (72%) of a published algorithm for identifying screening colonoscopies using Veterans Health Administration (VHA) administrative data.

Methods: We validated three algorithms for determining colonoscopy indication using medical records as the gold standard in a national sample of 650 patients. Algorithms used International Classification of Diseases, 9th Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Medical records were manually abstracted using standardized protocols.

Results: The best algorithm had 83% sensitivity and 76% specificity for screening indication. Over 99% of colonoscopy CPT codes corresponded to a colonoscopy in the medical record.

Conclusions: VHA procedure codes are very accurate for colonoscopy utilization; however, algorithms to ascertain indication have only moderate accuracy.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Colonoscopy / statistics & numerical data*
  • Current Procedural Terminology
  • Data Mining*
  • Databases as Topic
  • Electronic Health Records
  • Female
  • Health Services Research
  • Humans
  • International Classification of Diseases
  • Male
  • Mass Screening / methods
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Patient Selection*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Time Factors
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data*