J Am Med Inform Assoc - ICD-9 tobacco use codes are effective identifiers of smoking status.

Tópicos

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Resumo

JECTIVE: To evaluate the validity of, characterize the usage of, and propose potential research applications for International Classification of Diseases, Ninth Revision (ICD-9) tobacco codes in clinical populations.MATERIALS AND METHODS: Using data on cancer cases and cancer-free controls from Vanderbilt's biorepository, BioVU, we evaluated the utility of ICD-9 tobacco use codes to identify ever-smokers in general and high smoking prevalence (lung cancer) clinic populations. We assessed potential biases in documentation, and performed temporal analysis relating transitions between smoking codes to smoking cessation attempts. We also examined the suitability of these codes for use in genetic association analyses.RESULTS: ICD-9 tobacco use codes can identify smokers in a general clinic population (specificity of 1, sensitivity of 0.32), and there is little evidence of documentation bias. Frequency of code transitions between 'current' and 'former' tobacco use was significantly correlated with initial success at smoking cessation (p<0.0001). Finally, code-based smoking status assignment is a comparable covariate to text-based smoking status for genetic association studies.DISCUSSION: Our results support the use of ICD-9 tobacco use codes for identifying smokers in a clinical population. Furthermore, with some limitations, these codes are suitable for adjustment of smoking status in genetic studies utilizing electronic health records.CONCLUSIONS: Researchers should not be deterred by the unavailability of full-text records to determine smoking status if they have ICD-9 code histories.

Resumo Limpo

jectiv evalu valid character usag propos potenti research applic intern classif diseas ninth revis icd tobacco code clinic populationsmateri method use data cancer case cancerfre control vanderbilt biorepositori biovu evalu util icd tobacco use code identifi eversmok general high smoke preval lung cancer clinic popul assess potenti bias document perform tempor analysi relat transit smoke code smoke cessat attempt also examin suitabl code use genet associ analysesresult icd tobacco use code can identifi smoker general clinic popul specif sensit littl evid document bias frequenc code transit current former tobacco use signific correl initi success smoke cessat p final codebas smoke status assign compar covari textbas smoke status genet associ studiesdiscuss result support use icd tobacco use code identifi smoker clinic popul furthermor limit code suitabl adjust smoke status genet studi util electron health recordsconclus research deter unavail fulltext record determin smoke status icd code histori

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