Accuracy of syndrome definitions based on diagnoses in physician claims

BMC Public Health

Table 2 Accuracy of ICD-9 coded diagnoses in physician claims, as compared to ICD-9 coded diagnoses from physician-facilitated medical chart review, for identifying constitutional, gastrointestinal, neurological, rash, and respiratory syndrome, as well as influenza-like illness (ILI) (N = 10,529 visits with matched claim-record pair)

Syndrome definition	No. visits in verified claims	No. visits in verified charts	Sensivity (95% CI)	Specificity (95% CI)	PPV (95% CI)	NPV (95% CI)
*CDC and DoD ESSENCE* ¹
Fever	601	656	0.11 (0.10, 0.13)	0.99 (0.99, 0.99)	0.59 (0.55, 0.64)	0.94 (0.93, 0.95)
Gastrointestinal	855	888	0.23 (0.20, 0.26)	0.99 (0.99, 0.99)	0.71 (0.66, 0.75)	0.94 (0.94, 0.95)
Neurological	971	693	0.17 (0.14, 0.21)	1.00 (1.00, 1.00)	0.67 (0.64, 0.70)	0.98 (0.98, 0.98)
Rash	897	905	0.20 (0.18, 0.23)	0.99 (0.99, 0.99)	0.66 (0.62, 0.70)	0.95 (0.95, 0.96)
Respiratory	1,049	1,779	0.44 (0.41, 0.47)	0.97 (0.96, 0.98)	0.85 (0.83, 0.88)	0.84 (0.83, 0.85)
*RODS* ²
Fever	873	961	0.14 (0.12, 0.16)	0.99 (0.99, 0.99)	0.60 (0.56, 0.64)	0.91 (0.90, 0.92)
Gastrointestinal	703	834	0.20 (0.18, 0.23)	0.99 (0.99, 0.99)	0.68 (0.63, 0.73)	0.94 (0.94, 0.95)
Neurological	874	523	0.16 (0.13, 0.20)	1.00 (1.00, 1.00)	0.52 (0.48, 0.55)	0.99 (0.98, 0.99)
Rash	814	718	0.12 (0.10, 0.14)	1.00 (1.00, 1.00)	0.63 (0.59, 0.66)	0.96 (0.96, 0.97)
Respiratory	665	1,209	0.29 (0.26, 0.32)	0.98 (0.98, 0.98)	0.74 (0.70, 0.79)	0.87 (0.86, 0.88)
*Influenza-like illness* ³
Large-group	653	1,232	0.38 (0.35, 0.41)	0.98 (0.98, 0.98)	0.77 (0.73, 0.81)	0.88 (0.87, 0.89)
Small-group	53	49	0.18 (0.12, 0.26)	1.00 (1.00, 1.00)	0.29 (0.16, 0.41)	0.99 (0.99, 0.99)

¹ Syndrome case definitions developed and published by the US Centers for Disease Control and Prevention (CDC) in 2003, and used by the US Department of Defense's Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE).
² Syndrome case definitions developed in the context of the University of Pittsburgh's Real-time Outbreak and Disease Surveillance (RODS) system.
³ Syndrome case definitions developed in the context of the US Department of Defense's Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE).

ISSN: 1471-2458