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

Ascertainment of colonoscopy indication using administrative data.

Author information

1
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA. fishe034@mc.duke.edu

Abstract

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.

PMID:
20393875
DOI:
10.1007/s10620-010-1200-y
[Indexed for MEDLINE]

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