Key result
ICD-10 codes show ~72% sensitivity for identifying VTE in electronic databases.
Why the study?
The accuracy of ICD-10 codes for identifying venous thromboembolism, including DVT and PE, in administrative databases remains unclear.
Are ICD-10 codes accurate for identifying VTE in adult and pediatric patients?
Meta-Analysis
Are ICD-10 codes accurate for identifying VTE in adult and pediatric patients?
Effect estimate: Sensitivity (95% CI 60-85)
ICD-10 codes have moderate-to-high sensitivity and specificity for identifying VTE in electronic databases, though the certainty of evidence is low.
Moderate accuracy of ICD-10 VTE codes warrants caution in database studies; leaves open the value of supplementary validation methods.
The identification of venous thromboembolism (VTE) using administrative databases is frequently required for reporting and research. The accuracy of International Classification of Diseases 10th revision (ICD-10) codes for VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE), remains unclear. We examined the accuracy of ICD-10 codes for identifying VTE in adult and pediatric inpatients and outpatients. For this systematic review and meta-analysis, we searched MEDLINE, EMBASE, Web of Science, CENTRAL, Epistemonikos and McMaster Superfilters from inception to July 25, 2023 for studies evaluating the sensitivity, specificity, positive predictive value (PPV), and/or negative predictive value (NPV) of ICD-10 codes for VTE in any anatomical location. We assessed risk of bias using QUADAS and certainty of evidence using GRADE. We calculated pooled sensitivity and specificity with 95% confidence intervals (CI) using a random-effects model. We included 24 studies in the qualitative synthesis and 7 in the meta-analysis. Pooled sensitivity for any VTE based on ICD-10 codes was 72% (95% CI 60–85%, low certainty); pooled specificity was 82% (95% CI 76–88%, low certainty). The PPV for ICD-10 VTE codes ranged from 0% to 100% (median: 80%) while the NPV ranged from 95.4% to 100% (median: 100%). ICD-10 codes for PE had a higher pooled sensitivity (91%) than for DVT (58%). ICD-10 codes have moderate-to-high sensitivity and specificity for the identification of VTE in electronic databases. The certainty of evidence is low due to inconsistency and risk of bias. Further robust studies validating ICD-10 VTE codes are needed to improve reporting and better understand coding limitations.
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Liu et al. (2023) conducted a meta-analysis in Venous thromboembolism (VTE). ICD-10 codes was evaluated on Pooled sensitivity for any VTE based on ICD-10 codes (Sensitivity, 95% CI 60-85). ICD-10 codes for venous thromboembolism demonstrated a pooled sensitivity of 72% (95% CI 60-85%) and a pooled specificity of 82% (95% CI 76-88%) for identifying VTE in electronic databases.
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