Key result
ICD-10 code I26 detects acute PE in EDs with high specificity but modest ~51% sensitivity.
Why the study?
The study evaluated the diagnostic accuracy of the I26 leader ICD-10 code for near real-time detection of acute PE within an emergency department surveillance network.
Does the ICD-10 code I26 accurately detect acute pulmonary embolism in an ED surveillance network?
Observational
Yes
Does the ICD-10 code I26 accurately detect acute pulmonary embolism in an ED surveillance network?
The ICD-10 code I26 provides high specificity but modest sensitivity for near real-time surveillance of acute pulmonary embolism in emergency departments.
Supports specific-case capture in ED PE surveillance networks; leaves open need for sensitivity validation in prospective cohorts.
Background: Emergency departments (EDs) offer a unique platform for a surveillance network for acute pulmonary embolism (PE) using International Classification of Disease (ICD-10) codes extracted from electronic medical records. Objectives: Test the diagnostic accuracy of the I26 "leader" ICD-10 code for the detection of PE in near real-time in a large, ED-based surveillance network. Methods: ). The primary outcome was diagnostic accuracy of the I26 leader compared with the final adjudication. On a weekly basis, the I26 leader had a sensitivity of 50.9% (95% CI, 46.1%-55.6%) and a specificity of 99.7% (95% CI, 99.5%-99.8%), likelihood ratio (LR) negative of 0.49 (95% CI, 0.44-0.54) and LR positive of 191 (95% CI, 116-12). At 1 month, the I26 sensitivity was 57.5% (95% CI, 52.7%-62.1%), and specificity was 99.5% (95% CI, 99.2%-99.6%); LRnegative of 0.43 (95% CI, 0.38-0.47) and LRpositive of 111 (95% CI, 77-159). Conclusion: For low-latency surveillance of PE diagnosed in EDs, the ICD leader code I26 affords high specificity and high LR(+) for detection of acute PE in the United States but has modest sensitivity.
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Kline et al. (2025) conducted an observational in Acute pulmonary embolism. ICD-10 code I26 vs. Final adjudication was evaluated on Diagnostic accuracy of the I26 leader compared with the final adjudication (Sensitivity 50.9%, 95% CI 46.1%-55.6%). The ICD-10 leader code I26 demonstrated high specificity (99.7%) but modest sensitivity (50.9%) for detecting acute pulmonary embolism in emergency departments.
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