Development and validation of a case definition for epilepsy for use with administrative health data

Aylin Y. Reid, Christine St.Germaine-Smith, Mingfu Liu, Shahnaz Sadiq, Hude Quan, Samuel Wiebe, Peter Faris, Stafford Dean, Nathalie Jetté

Research output: Contribution to journalArticlepeer-review

81 Scopus citations

Abstract

The objective of this study was to develop and validate coding algorithms for epilepsy using ICD-coded inpatient claims, physician claims, and emergency room (ER) visits. 720/2049 charts from 2003 and 1533/3252 charts from 2006 were randomly selected for review from 13 neurologists' practices as the "gold standard" for diagnosis. Epilepsy status in each chart was determined by 2 trained physicians. The optimal algorithm to identify epilepsy cases was developed by linking the reviewed charts with three administrative databases (ICD 9 and 10 data from 2000 to 2008) including hospital discharges, ER visits and physician claims in a Canadian health region. Accepting chart review data as the gold standard, we calculated sensitivity, specificity, positive, and negative predictive value for each ICD-9 and ICD-10 administrative data algorithm (case definitions). Of 18 algorithms assessed, the most accurate algorithm to identify epilepsy cases was "2 physician claims or 1 hospitalization in 2 years coded" (ICD-9 345 or G40/G41) and the most sensitive algorithm was "1 physician clam or 1 hospitalization or 1 ER visit in 2 years." Accurate and sensitive case definitions are available for research requiring the identification of epilepsy cases in administrative health data.

Original languageEnglish
Pages (from-to)173-179
Number of pages7
JournalEpilepsy Research
Volume102
Issue number3
DOIs
StatePublished - Dec 2012
Externally publishedYes

Keywords

  • Accuracy
  • ICD-10
  • ICD-9
  • International Classification of Disease
  • Seizure

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