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10.3171/2015.10.PEDS15370

http://scihub22266oqcxt.onion/10.3171/2015.10.PEDS15370
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C4853277!4853277!26799412
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suck abstract from ncbi


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pmid26799412      J+Neurosurg+Pediatr 2016 ; 17 (5): 519-24
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  • Chiari malformation Type I surgery in pediatric patients Part 1: validation of an ICD-9-CM code search algorithm #MMPMID26799412
  • Ladner TR; Greenberg JK; Guerrero N; Olsen MA; Shannon CN; Yarbrough CK; Piccirillo JF; Anderson RCE; Feldstein NA; Wellons JC; Smyth MD; Park TS; Limbrick DD
  • J Neurosurg Pediatr 2016[May]; 17 (5): 519-24 PMID26799412show ga
  • Objective: Administrative billing data may facilitate large-scale assessments of treatment outcomes for pediatric Chiari malformation Type I (CM-I). Validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code algorithms for identifying CM-I surgery are critical prerequisites for such studies but are currently only available for adults. The objective of this study was to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing CM-I decompression surgery. Methods: The authors retrospectively analyzed the validity of two ICD-9-CM code algorithms for identifying pediatric CM-I decompression surgery performed at 3 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-I), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression or laminectomy). Algorithm 2 restricted this group to the subset of patients with a primary discharge diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. Results: Among 625 first-time admissions identified by Algorithm 1, the overall PPV for CM-I decompression was 92%. Among the 581 admissions identified by Algorithm 2, the PPV was 97%. The PPV for Algorithm 1 was lower in one center (84%) compared with the other centers (93%?94%), whereas the PPV of Algorithm 2 remained high (96%?98%) across all subgroups. The sensitivity of Algorithms 1 (91%) and 2 (89%) was very good and remained so across subgroups (82%?97%). Conclusions: An ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent PPV and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. These results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.
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