Su2089 Validation of the Use of the ICD-10 Diagnostic Code for Irritable Bowel Syndrome in the Swedish National Patient Register

ObjectivesIn the International Classification of Diseases, Tenth Edition (ICD-10), hypochondriasis (illness anxiety disorder) and dysmorphophobia (body dysmorphic disorder) share the same diagnostic code (F45.2). However, the Swedish ICD-10 allows for these disorders to be coded separately (F45.2 and F45.2A, respectively), potentially offering unique opportunities for register-based research on these conditions. We assessed the validity and reliability of their ICD-10 codes in the Swedish National Patient Register (NPR).DesignRetrospective chart review.MethodsSix hundred individuals with a diagnosis of hypochondriasis or dysmorphophobia (300 each) were randomly selected from the NPR. Their medical files were requested from the corresponding clinics, located anywhere in Sweden. Two independent raters assessed each file according to ICD-10 definitions and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and Fifth Edition criteria. Raters also completed the Clinical Global Impression–Severity (CGI-S) and the Global Assessment of Functioning (GAF).Primary outcome measurePer cent between-rater agreement and positive predictive value (PPV). Intraclass correlation coefficients for the CGI-S and the GAF.ResultsEighty-four hypochondriasis and 122 dysmorphophobia files were received and analysed. The inter-rater agreement rate regarding the presence or absence of a diagnosis was 95.2% for hypochondriasis and 92.6% for dysmorphophobia. Sixty-seven hypochondriasis files (79.8%) and 111 dysmorphophobia files (91.0%) were considered ‘true positive’ cases (PPV=0.80 and PPV=0.91, respectively). CGI-S scores indicated that symptoms were moderately to markedly severe, while GAF scores suggested moderate impairment for hypochondriasis cases and moderate to serious impairment for dysmorphophobia cases. CGI-S and GAF inter-rater agreement were good for hypochondriasis and moderate for dysmorphophobia.ConclusionsThe Swedish ICD-10 codes for hypochondriasis and dysmorphophobia are sufficiently valid and reliable for register-based studies. The results of such studies should be interpreted in the context of a possible over-representation of severe and highly impaired cases in the register, particularly for dysmorphophobia.

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Validity and reliability of social anxiety disorder diagnoses in the Swedish National Patient Register

10.31234/osf.io/yvntq ◽

2019 ◽

Author(s):

Alba Vilaplana-Pérez ◽

Josef Isung ◽

Sonja Matu Marjatta Krig ◽

Sarah Vigerland ◽

Maral Jolstedt ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Rater Agreement ◽

Predictive Values ◽

National Patient Register ◽

Patient Register ◽

National Patient ◽

Icd 10 ◽

The Impact

BACKGROUND: Population-based administrative registers are often used for research purposes. However, their potential usefulness depends on the validity of the registered information. This study assessed the validity of the recorded codes for social anxiety disorder (SAD) in the Swedish National Patient Register (NPR). METHODS: The personal identification numbers of 300 randomly selected individuals with a diagnosis of SAD (also known as social phobia) recorded in the NPR were obtained from the Swedish National Board of Health and Welfare. The medical files of these individuals were then requested from clinics nationally. A total of 117 files were received and two independent raters reviewed each file to assess the presence or absence of SAD, according to the definition of the International Classification of Diseases, Tenth Edition (ICD-10) and the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). When disagreements between the two raters were found, a third rater reviewed the file to establish a best estimate diagnosis. Positive predictive values (PPV) and agreement between the two initial raters (using Cohen’s kappa) were calculated. Additionally, raters completed the Clinical Global Impression – Severity (CGI-S) and the Global Assessment of Functioning (GAF) rating scales for each file. Inter-rater agreement for the CGI-S and the GAF was assessed using intraclass correlation coefficients (ICC).RESULTS: After exclusion of files not comprising sufficient information, 95 files were included in the analyses. Of these, 77 files (81.05%) were considered to be ‘true positive’ cases. This resulted in a PPV of 0.81 (95% confidence interval, 0.72-0.88). Inter-rater agreement regarding the presence or absence of SAD was substantial (κ=0.72). CGI-S and GAF scores indicated that patients were in the moderate range of severity and functional impairment. Inter-rater agreement for the CGI-S and the GAF was moderate to good (ICC=0.72 and ICC=0.82, respectively). CONCLUSIONS: The ICD-10 codes for SAD in the Swedish NPR are generally valid and reliable, but we recommend sensitivity analyses in future register-based studies to minimise the impact of potential diagnostic misclassification. Most patients were moderately severe and impaired, suggesting that results from register-based studies of SAD may be generalizable.

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Diagnostic Differences Among Different Ethnic Groups Contacting Mental Health Services

European Psychiatry ◽

10.1016/s0924-9338(09)70301-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

M. Kastrup

Keyword(s):

Ethnic Groups ◽

Explanatory Models ◽

Western Countries ◽

National Patient Register ◽

Patient Register ◽

National Patient ◽

Use Of Services ◽

Icd 10 ◽

Nationwide Register Study ◽

Migrant Groups

Aim:A nationwide register study was carried out in Denmark comprising 50,877 persons aged 18-66, who were registered in 2003 in the Danish Psychiatric Register or the National Patient Register with a psychiatric ICD-10 diagnosis with the aim to compare diagnostic profiles and use of services.Method:The study is a register survey linking Psychiatric/and National Patient Register with Statistical Bureau data.Results:Of the population 87.1% were ethnic Danes, 7.8% migrants, 4.0% descendants with one Danish born parent, 0.7% descendants with both parents born outside Denmark and 0.3% foreign adoptees. Males comprised 49%, women 51% of the population. The 5 ethnic groups had significant differences in utilization of care, in diagnostic distribution and in the use of coercion. Diagnostically, contacts due to schizophrenia were significantly higher among non-Danish patients and highest among young descendant males. Personality disorders were significantly higher among women than men and highes in adopted and descendant young women. PTSD had a preponderance among migrant men. Substance abuse was higher among men in all ethnic groups, but lower among migrant groups compared to Danes. Self-mutilating behaviour was seen more frequently among female descendants from non-Western countries than among migrant women from non-Western countries as well as among young adopted women.Conclusion:Significant diagnostic differences were observed. Possible explanatory models to these findings will be discussed.

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Gender differences in delays to diagnosis of acromegaly: data from the Swedish National Patient Register

Endocrine Abstracts ◽

10.1530/endoabs.56.p158 ◽

2018 ◽

Author(s):

Daniel Granfeldt ◽

AEse Bjorstad ◽

Marlow Tom ◽

Anthony Berthon ◽

Jerome Dinet ◽

...

Keyword(s):

Gender Differences ◽

National Patient Register ◽

Patient Register ◽

National Patient

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Validity and reliability of social anxiety disorder diagnoses in the Swedish National Patient Register

BMC Psychiatry ◽

10.1186/s12888-020-02644-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Alba Vilaplana-Pérez ◽

Josef Isung ◽

Sonja Krig ◽

Sarah Vigerland ◽

Maral Jolstedt ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Validity And Reliability ◽

National Patient Register ◽

Patient Register ◽

National Patient

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Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register

10.21203/rs.2.11770/v2 ◽

2019 ◽

Author(s):

Anders Forss ◽

Pär Myrelid ◽

Ola Olén ◽

Åsa H Everhov ◽

Caroline Nordenvall ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Sensitivity And Specificity ◽

Bowel Disease ◽

Surgical Procedure ◽

High Sensitivity ◽

National Patient Register ◽

Patient Register ◽

National Patient ◽

Inflammatory Bowel ◽

Procedure Codes

Abstract Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register Background: About 50% of patients with Crohn’s disease (CD) and about 20% of those with ulcerative colitis (UC) undergo surgery at some point during the course of the disease. The diagnostic validity of the Swedish National Patient Register (NPR) has previously been shown to be high for inflammatory bowel disease (IBD), but there are little data on the validity of IBD-related surgical procedure codes. Methods: Using patient chart data as the gold standard, surgical procedure codes registered between 1966 and 2014 in the NPR were abstracted and validated in 262 patients with a medical diagnosis of IBD. Of these, 53 patients had reliable data about IBD-related surgery. The positive predictive value (PPV), sensitivity and specificity of the surgical procedure codes were calculated. Results: In total, 158 codes were registered in the NPR. 155 of these, representing 60 different surgical procedure codes, were also present in the patient charts and validated using a standardized form. Of the validated codes 153/155 were concordant against the patient charts, corresponding to a PPV of 96.8% (95%CI=93.9-99.1). Stratified in abdominal, perianal and other surgery, the corresponding PPVs were 94.1% (95%CI=88.7-98.6), 100% (95%CI=100-100) and 98.1% (95%CI=93.1-100), respectively. Of 164 surgical procedure codes in the validated patient charts, 155 were registered in the NPR, corresponding to a sensitivity of the surgical procedure codes of 94.5% (95%CI=89.6-99.3). The specificity of the NPR was 98.5% (95%CI=97.6-100). Conclusions: Data on IBD-related surgical procedure codes are reliable, with the Swedish National Patient Register showing a high sensitivity and specificity for such surgery. Keywords: Epidemiology, Inflammatory bowel disease, Validation, National Patient Register, Procedure code

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Risk of first and recurrent serious infection in sarcoidosis: a Swedish register-based cohort study

European Respiratory Journal ◽

10.1183/13993003.00767-2020 ◽

2020 ◽

Vol 56 (3) ◽

pp. 2000767 ◽

Cited By ~ 1

Author(s):

Marios Rossides ◽

Susanna Kullberg ◽

Anders Eklund ◽

Daniela Di Giuseppe ◽

Johan Grunewald ◽

...

Keyword(s):

General Population ◽

International Classification Of Diseases ◽

Parametric Models ◽

National Patient Register ◽

Patient Register ◽

Drug Register ◽

Serious Infection ◽

Increased Risk ◽

Serious Infections ◽

National Patient

Serious infections impair quality of life and increase costs. Our aim was to determine if sarcoidosis is associated with a higher rate of serious infection and whether this varies by age, sex, time since diagnosis or treatment status around diagnosis.We compared individuals with sarcoidosis (at least two International Classification of Diseases codes in the Swedish National Patient Register 2003–2013; n=8737) and general population comparators matched 10:1 on age, sex and residential location (n=86 376). Patients diagnosed in 2006–2013 who were dispensed at least one immunosuppressant ±3 months from diagnosis (Swedish Prescribed Drug Register) were identified. Cases and comparators were followed in the National Patient Register for hospitalisations for infection. Using Cox and flexible parametric models, we estimated adjusted hazard ratios (aHR) and 95% confidence intervals for first and recurrent serious infections (new serious infection >30 days after previous).We identified 895 first serious infections in sarcoidosis patients and 3881 in comparators. The rate of serious infection was increased 1.8-fold in sarcoidosis compared to the general population (aHR 1.81, 95% CI 1.65–1.98). The aHR was higher in females than males and during the first 2 years of follow-up. Sarcoidosis cases treated with immunosuppressants around diagnosis had a three-fold increased risk, whereas nontreated patients had a 50% increased risk. The rate of serious infection recurrence was 2.8-fold higher in cases than in comparators.Serious infections are more common in sarcoidosis than in the general population, particularly during the first few years after diagnosis. Patients who need immunosuppressant treatment around diagnosis are twice as likely to develop a serious infection than those who do not.

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