Positive Predictive Value of French Hospitalization Discharge Codes for Stroke and Transient Ischemic Attack

Eur Neurol. 2015;74(1-2):92-9. doi: 10.1159/000438859. Epub 2015 Aug 22.

Abstract

Background: We aimed at measuring the positive predictive value (PPV) of data in the French Hospital Medical Information Database (FHD).

Summary: This retrospective multicenter study included 31 hospitals from where 56 hospital stays were randomly selected among all hospitalizations for the years 2009 and 2010 with at least 1 principal diagnosis of stroke or transient ischemic attack (TIA). Three algorithms were evaluated. Algorithm 1 selected discharge abstracts with at least 1 principal diagnosis identified by one of the relevant International Classification of Diseases, 10th revision codes. Algorithm 2 selected stays with 1 principal diagnosis of the whole stay, but without the dates of the stay. Algorithm 3 took into account the kind of medical wards. The PPV of each algorithm was calculated using medical records as the reference. We found 1,669 discharge abstracts with a diagnosis of stroke among the 1,680 that were randomly selected. The neurologist's review revealed 196 false-positive cases providing a global PPV of 88.26% for algorithm 1, 89.96% for algorithm 2 and 92.74% for algorithm 3.

Key messages: It was possible to build an algorithm to optimize the FHD for stroke and TIA reporting, with a PPV at 90%. The FHD could be a good tool to measure the burden of stroke in France.

MeSH terms

  • Aged
  • Algorithms
  • Aphasia / diagnosis
  • Brain / diagnostic imaging
  • Clinical Coding
  • Databases, Factual
  • Female
  • France
  • Hemiplegia / diagnosis
  • Hospitalization
  • Humans
  • International Classification of Diseases*
  • Ischemic Attack, Transient / diagnosis*
  • Magnetic Resonance Imaging
  • Male
  • Medical Records
  • Middle Aged
  • Patient Discharge*
  • Retrospective Studies
  • Stroke / diagnosis*
  • Tomography, X-Ray Computed