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Table 2 Agreement and Accuracy between Chart and Administrative Data by Study Year, N = 3'449*

From: Improved accuracy of co-morbidity coding over time after the introduction of ICD-10 administrative data

 

1999

(n = 1'158)

2001

(n = 1'195)

2003

(n = 1'146)

Comparison across years

COMORBIDITIES

Se

PPV

Kappa

Se

PPV

Kappa

Se

PPV

Kappa

P-value**

 

%

%

k

(95% CI)

%

%

k

(95% CI)

%

%

k

(95% CI)

Se

PPV

Cardiac arrhythmias2

35.3

98.8

0.48

(0.38-0.54)

43.9

96.4

0.55

(0.48-0.62)

56.1

89

0.65

(0.57-0.70)†††

0.001

0.022

Congestive heart failure1,2

20.8

82.3

0.27

(0.17-0.32)

23.8

84.9

0.31

(0.22-0.37)

26.3

83.4

0.38

(0.28-0.44)

0.193

0.898

Myocardial infraction1(a)

43

56.9

0.47

(0.36-0.60)

71.5

61.4

0.65

(0.52-0.75)

56.2

69

0.6

(0.48-0.72)

0.109

615

PVD1,2

24.7

90.4

0.35

(0.22-0.41)

22.2

94.3

0.3

(0.20-0.34)

33.1

94.6

0.4

(0.30-0.47)

0.391

0.792

PCD2

34.1

82.9

0.47

(0.33-0.62)

36.1

79

0.5

(0.36-0.62)

38.6

78.5

0.51

(0.37-0.64)

0.934

0.984

Valvular disease2

31.3

93.8

0.44

(0.34-0.54)

30.8

93.7

0.43

(0.32-0.50)

60.6

88

0.65

(0.56-0.72)††/†††

0.001

0.816

CEVD1,2

35.7

78.1

0.46

(0.35-0.55)

31.7

71.2

0.43

(0.33-0.51)

47.3

78.6

0.54

(0.44-0.63)

0.18

0.951

Hemiplegia or araplegia1,2

17.4

90.6

0.31

(0.19-0.43)

26.1

96.2

0.39

(0.27-0.50)

37

94.3

0.45

(0.32-0.56)

0.307

0.86

Hypertension 2

49.6

94.1

0.6

(0.53-0.64)

66.5

94.9

0.71

(0.67-0.76)†

76.5

95.4

0.77

(0.73-0.81) ††/†††

< 0.001

0.921

CPD1,2

30.6

87.2

0.45

(0.35-0.53)

47.5

94.8

0.6

(0.52-0.67)†

44.2

82.8

0.54

(0.44-0.59)

0.052

0.097

Diabetes

              

- with complication1,2

45.2

81.9

0.57

(0.42-0.72)

43

69.6

0.52

(0.35-0.68)

41.3

87

0.55

(0.42-0.68)

0.969

0.394

- without complication1,2

60

76.7

0.69

(0.59-0.76)

64.6

80.3

0.7

(0.62-0.77)

75.6

82.6

0.72

(0.64-0.78)

0.584

0.83

Hypothyroidism2

39

92.5

0.59

(0.40-0.74)

57.8

95.8

0.71

(0.59-0.80)

44.2

82

0.61

(0.47-0.72)

0.461

0.5

Peptic ulcer1

21.2

85.8

0.33

(0.19-0.49)

42

86

0.55

(0.38-0.67)

27.8

100

0.47

(0.32-0.60)

0.221

0.866

Peptic ulcer (ex. bleeding) 2

3.1

40

0.05

(0.00-0.23)

15.4

65.4

0.24

(0.10-0.41)

7.4

50.5

0.16

(0.05-0.33)

0.326

0.685

Liver disease2

36.3

90.3

0.5

(0.39-0.62)

35.8

84.4

0.48

(0.39-0.60)

44.8

97.8

0.63

(0.51-0.72)

0.329

0.265

- Mild liver disease1

49.4

81.4

0.6

(0.47-0.73)

48.4

68.3

0.56

(0.41-0.70)

51

78.5

0.66

(0.52-0.76)

0.916

0.299

- MSLD1

27.3

50

0.35

(0.08-0.78)

37.2

35.9

0.36

(0.14-0.63)

87.5

62.2

0.73

(0.46-0.90)

0.169

0.495

Any Tumor1

42.8

40.2

0.36

(0.28-0.46)

52.1

54.1

0.48

(0.39-0.55)

47.8

44.4

0.44

(0.35-0.52)

0.445

0.247

Lymphoma1,2

46.9

100

0.2

-

67.1

91.1

0.21

-

43.1

87.8

0.06

-

0.197

-

Metastatic cancer1,2

32

97.4

0.49

(0.38-0.59)

57.2

90.6

0.68

(0.59-0.75)

56.6

94.2

0.69

(0.61-0.74)††

0.007

0.502

STWM2

40.6

39.7

0.35

(0.26-0.44)

50

54.5

0.47

(0.38-0.54)

42.1

35.5

0.32

(0.25-0.42)

0.388

0.019

Renal failure1,2

42.7

97.6

0.61

(0.51-0.68)

38.2

94.8

0.52

(0.43-0.60)

36.6

92.8

0.49

(0.38-0.56)†††

0.204

0.351

Rheumatic disease1,2

37.2

100

0.54

-

55.4

93.8

0.69

-

26.8

92.2

0.41

-

0.049

-

AIDS/HIV1,2

64.1

100

0.78

(0.55-0.92)

50

100

0.67

(0.29-0.88)

16.8

66.7

0.27

(0.08-0.57)

0.086

-

Blood loss anemia2

1.9

39.7

0.03

(0.02-0.16)

10.5

74.9

0.17

(0.07-0.29)

5.1

40.8

0.08

(0.00-0.16)

0.163

0.477

Deficiency anemia2

12.7

66.2

0.2

(0.09-0.38)

20.1

67.2

0.29

(0.17-0.41)

13.4

50

0.22

(0.11-0.39)

0.691

0.623

Coagulopathy2

34.2

91.7

0.49

(0.34-0.65)

24.8

92.8

0.38

(0.24-0.51)

27.5

87.9

0.4

(0.28-0.52)

0.561

0.97

FED2

16.6

85.5

0.26

(0.15-0.37)

21.3

84.6

0.32

0.20-0.41)

32.9

86.7

0.43

(0.33-0.51)

0.031

0.978

Weight loss2

14.1

100

0.24

-

17.1

100

0.28

-

14.6

100

0.25

 

0.816

-

Obesity2

29.4

92.1

0.43

(0.34-0.55)

39.5

81.1

0.51

(0.42-0.63)

51.5

91.7

0.68

(0.57-0.76)†††

0.013

0.21

Alcohol abuse2

39

90.4

0.53

(0.43-0.65)

54.4

84.5

0.64

(0.55-0.74)

51.9

91.2

0.64

(0.55-0.73)

0.183

0.444

Drug abuse2

37.8

76.1

0.5

(0.32-0.67)

47.7

91.4

0.62

(0.45-0.79)

41.8

79.7

0.54

(0.38-0.65)

0.682

0.541

Dementia1

48.8

71.6

0.6

(0.42-0.74)

40.9

64.9

0.49

(0.31-0.66)

53.5

67

0.61

(0.42-0.75)

0.57

0.832

Psychosis2

10.4

70

0.18

(0.05-0.45)

41.2

74.1

0.52

(0.34-0.71)

42

90.5

0.57

(0.35-0.74)

0.112

0.647

Depression2

42.3

92.2

0.56

(0.48-0.67)

56.7

95.7

0.69

(0.60-0.76)

53.9

89.8

0.65

(0.54-0.70)

0.236

0.632

  1. Se = Sensitivity, PPV = Positive predictive value, PCD = Pulmonary circulation disorders, PVD = Peripheral vascular disease, CEVD = Cerebrovascular disease, CPD = Chronic pulmonary disease, MSLD = Moderate and severe liver disease, STWM = Solid tumour without metastasis, FED = Fluid and electrolytic disorders.
  2. 1Charlson co-morbidities; 2Elixhauser co-morbidities.
  3. (a) Only recent myocardial infraction
  4. *Sample size without weighted sampling fraction (i.e., observed sample size)
  5. **Global Wald test
  6. † Difference was significant for comparison between 1999 and 2001, †† between 2001 and 2003, and ††† between 1999 and 2003.