How Accurate Are International Classification of Diseases-10 Diagnosis Codes in Detecting Influenza and Pertussis Hospitalizations in Children?

Hannah C Moore; Deborah Lehmann; Nicholas de Klerk; David W Smith; Peter C Richmond; Anthony D Keil; Christopher C Blyth

doi:10.1093/jpids/pit036

How Accurate Are International Classification of Diseases-10 Diagnosis Codes in Detecting Influenza and Pertussis Hospitalizations in Children?

J Pediatric Infect Dis Soc. 2014 Sep;3(3):255-60. doi: 10.1093/jpids/pit036. Epub 2013 Jul 4.

Authors

Hannah C Moore¹, Deborah Lehmann¹, Nicholas de Klerk¹, David W Smith², Peter C Richmond³, Anthony D Keil⁴, Christopher C Blyth⁵

Affiliations

¹ Division of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, and.
² School of Pathology and Laboratory Medicine, University of Western Australia Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, QEII Medical Centre.
³ School of Paediatrics and Child Health, University of Western Australia Department of Paediatric and Adolescent Medicine, Princess Margaret Hospital for Children.
⁴ Department of Microbiology, PathWest Laboratory Medicine WA, Princess Margaret Hospital for Children, Perth, Australia.
⁵ School of Paediatrics and Child Health, University of Western Australia Department of Paediatric and Adolescent Medicine, Princess Margaret Hospital for Children Department of Microbiology, PathWest Laboratory Medicine WA, Princess Margaret Hospital for Children, Perth, Australia.

PMID: 26625389
DOI: 10.1093/jpids/pit036

Abstract

Influenza and pertussis are major causes of pediatric morbidity. We measured the accuracy of their International Classification of Diseases (ICD-10-AM) diagnosis codes using linked population-based laboratory and hospital data in 245,249 children. Influenza diagnosis codes had high specificity (98.6%) and modest positive predictive value (PPV; 84.1%) and sensitivity (86.1%, 95% CI: 83.4%-88.6%) for a laboratory-confirmed episode. For pertussis diagnosis codes, PPV (86.8%) and specificity (98.9%) were high, but sensitivity was poor (27.8%, 95% CI: 23.5%-32.4%). Measures varied according to age, remoteness, Aboriginality, severity, and detection method. Both laboratory and hospitalization data are needed to accurately determine the burden of pediatric influenza and pertussis.

Keywords: International Classification of Disease (ICD) Codes; hospitalization; influenza; laboratory confirmation; pertussis; sensitivity; specificity.