Performance of International Classification of Diseases, 9th Revision, Clinical Modification Codes as an Adverse Drug Event Surveillance System

BACKGROUND: Adverse drug events (ADEs) are one of the most frequent causes of iatrogenic injury. Because International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes are routinely assigned to inpatient discharges, they could provide a method to detect ADEs within a hospital, a state, and the nation. OBJECTIVE: The objective of this study was to determine validity of selected ICD-9-CM codes in identifying inpatient ADEs. RESEARCH DESIGN: An expert panel identified 416 ICD-9-CM codes to represent ADEs (flagged ADE codes). Retrospective chart review using a structured tool was performed to ascertain code performance in detecting ADEs. SUBJECTS: Subjects included 3103 inpatients from all 41 acute care hospitals in Utah in 2001: 1961 inpatients sampled randomly (random sample) and 1142 inpatients sampled from the discharge records with at least one flagged ADE code (flagged sample). MEASURES: Measures were ADEs identified by structured review. RESULTS: The flagged sample yielded 1122 flagged ADE codes recorded in patient charts with 704 representing ADEs (63%). Two hundred eighty-six of the 704 verified ADE codes (41%) were determined to be inpatient ADEs. In the random sample, 32 of 58 ADEs (55%) causing hospital admission were detected by the ADE-flagged codes. Only 23 of 224 inpatient ADEs had been assigned a flagged ADE code (10%). CONCLUSIONS: Flagged ADE codes have an overall positive predictive value of 63% and detect just over half of ADEs causing hospital admission. These codes have a positive predictive value of 25% for inpatient ADEs but detect only 10% of overall inpatient ADEs. Flagged ADE codes provide an imperfect but immediately available ADE surveillance system

Adverse drug event · Adverse effect · Adverse Event Reporting System · Drug · Event (particle physics) · Intensive care medicine · Computer Science · Medical Coding and Health Information · Medicine · Patient Safety and Medication Errors · Pharmacology · Pharmacovigilance and Adverse Drug Reactions

• Eventos adversos a medicamentos em hospital terciario

  Open Access•Suely Rozenfeld, Fabíola Giordani et al.•Revista de Saúde Pública•2013

  Añadir item

• Adverse drug events in hospitals

  Open Access•Fabíola Giordani Cano, Suely Rozenfeld•Cadernos de Saude Publica•2009

  Añadir item

• The Marginal Costs of Adverse Drug Events Associated With Exposures to Anticoagulants and Hypoglycemic Agents During Hospitalization

  William D Spector, Rhona Limcangco et al.•Medical Care•2017

  Añadir item

• Developing Indicators of Inpatient Adverse Drug Events Through Nonlinear Analysis Using Administrative Data

  Jonathan R Nebeker, Paul R Yarnold et al.•Medical Care•2007

  Añadir item

• Adverse drug events identified in hospitalized patients in Brazil by International Classification of Diseases (ICD-10) code listings

  Open Access•Ana Cristina Marques Martins, Ana Cristina Martins et al.•Cadernos de Saude Publica•2018

  Añadir item

• The Nature of Adverse Events in Hospitalized Patients

  LUCIAN L LEAPE, Troyen A Brennan et al.•New England Journal of Medicine•1991

  Añadir item

• Incidence and Types of Adverse Events and Negligent Care in Utah and Colorado

  Eric J Thomas, David M Studdert et al.•Medical Care•2000

  Añadir item

• International Classification of Diseases, 9th Revision, Clinical Modification Codes in Discharge Abstracts Are Poor Measures of Complication Occurrence in Medical Inpatients

  Jane M Geraci, Carol M Ashton et al.•Medical Care•1997

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