Abstract
Background
Administrative procedure code data can estimate colonoscopy utilization; however, determining colonoscopy indication is more difficult as procedure codes do not inherently reflect the purpose (screening, surveillance, diagnosis) of the colonoscopy.
Aim
To improve the reported sensitivity (70%) and specificity (72%) of a published algorithm for identifying screening colonoscopies using Veterans Health Administration (VHA) administrative data.
Methods
We validated three algorithms for determining colonoscopy indication using medical records as the gold standard in a national sample of 650 patients. Algorithms used International Classification of Diseases, 9th Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Medical records were manually abstracted using standardized protocols.
Results
The best algorithm had 83% sensitivity and 76% specificity for screening indication. Over 99% of colonoscopy CPT codes corresponded to a colonoscopy in the medical record.
Conclusions
VHA procedure codes are very accurate for colonoscopy utilization; however, algorithms to ascertain indication have only moderate accuracy.
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Support
This study was funded by a pilot grant from the VA Colorectal Cancer QUERI (Quality Enhancement Research Initiative). Additional support was from a VA Health Services Research and Development Career Development Transition Award RCD 03-174 (Fisher). The study sponsors had no role in the study design, collection, analysis, interpretation of data, or the writing of this report. The authors have no disclosures.
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Fisher, D.A., Grubber, J.M., Castor, J.M. et al. Ascertainment of Colonoscopy Indication Using Administrative Data. Dig Dis Sci 55, 1721–1725 (2010). https://doi.org/10.1007/s10620-010-1200-y
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DOI: https://doi.org/10.1007/s10620-010-1200-y