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Pharmacoepidemiol Drug Saf. 2013 Aug;22(8):842-9. doi: 10.1002/pds.3447. Epub 2013 May 2.

Validity of diagnostic codes and prevalence of psoriasis and psoriatic arthritis in a managed care population, 1996-2009.

Author information

1
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.

Abstract

BACKGROUND:

Few population-based studies have reported the prevalence of psoriatic disease.

OBJECTIVE:

We validated computerized diagnoses to estimate the prevalence of psoriasis and psoriatic arthritis.

METHOD:

We identified adults with ≥1 ICD-9 diagnosis codes of 696.0 (psoriatic arthritis) or 696.1 (psoriasis) in clinical encounter data during 1996-2009 and used chart review to confirm the diagnoses in random samples of patients. We then used the best performing case-finding algorithms to estimate the point prevalence of psoriasis and psoriatic arthritis.

RESULTS:

The number of persons with a diagnosis for psoriasis (ICD-9 code 696.1) was 87 827. Chart review of a random sample of 101 cases with at least one dermatologist-rendered psoriasis code revealed a positive predictive value (PPV) of 90% (95% CI, 83-95) with sensitivity of 88% (95% CI, 80-93). Psoriatic arthritis (code 696.0) was recorded for 5187 patients, with the best performing algorithm requiring ≥2 diagnoses recorded by a rheumatologist or ≥1 diagnosis recorded by a rheumatologist together with ≥1 psoriasis diagnoses recorded by a dermatologist; the PPV was 80% (95% CI, 70-88) with sensitivity 73% (95% CI, 63-82). Among KPNC adults, the point prevalence of psoriasis, with or without psoriatic arthritis, was 939 (95% CI, 765-1142) per 100 000, and the overall prevalence of psoriatic arthritis, with or without psoriasis, was 68 (95% CI, 54-84) per 100 000.

CONCLUSION:

Within an integrated health care delivery system, the use of computerized diagnoses rendered by relevant disease specialists is a valid method for identifying individuals with psoriatic disease.

KEYWORDS:

computerized medical information; epidemiology; incidence, prevalence, health maintenance organizations; pharmacoepidemiology; psoriasis; psoriatic arthritis

PMID:
23637091
PMCID:
PMC3720770
DOI:
10.1002/pds.3447
[Indexed for MEDLINE]
Free PMC Article

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