Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2019; 25(37): 5619-5629
Published online Oct 7, 2019. doi: 10.3748/wjg.v25.i37.5619
Accuracy of an administrative database for pancreatic cancer by international classification of disease 10th codes: A retrospective large-cohort study
Young-Jae Hwang, Seon Mee Park, Soomin Ahn, Jong-Chan Lee, Young Soo Park, Nayoung Kim
Young-Jae Hwang, Jong-Chan Lee, Young Soo Park, Nayoung Kim, Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
Seon Mee Park, Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju 28644, South Korea
Soomin Ahn, Departments of Pathology, Seoul National University Bundang Hospital, Seoungnam 13620, South Korea
Nayoung Kim, Department of Internal Medicine and Institute of Liver Research and Tumor Microenvironment Global Core Research Center, Seoul National University College of Medicine, Seoul 08826, South Korea
Author contributions: Hwang YJ collected data, analyzed data and drafted the article; Park SM advised design of the protocol and edited the manuscript; Ahn S performed the pathologic diagnosis; Lee JC advised the protocol and revised the manuscript; Park YS and Kim N designed the protocol, and edited the manuscript; All authors have read and approved the final draft of this paper.
Supported by the National Research Foundation of Korea, No. 2011-0030001.
Institutional review board statement: This study was approved by the institutional review board of the Ethics Committee of Seoul National University Bundang Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because our study was done retrospectively. Data for study were obtained after each patient agreed to treatment.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: To gain access to data, data requestors will need to sign a data access agreement. Proposals should be directed to the Ethics Committee of Seoul National University Bundang Hospital.
STROBE statement: The guidelines of the STROBE statement have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Nayoung Kim, MD, PhD, Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Seongnam 13620, South Korea. nakim49@snu.ac.kr
Telephone: +82-31-7877008 Fax: +82-31-7874051
Received: July 22, 2019
Peer-review started: July 22, 2019
First decision: August 27, 2019
Revised: September 3, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 7, 2019
Abstract
BACKGROUND

Korean National Health Insurance (NHI) claims database provides large-cohort. However, studies regarding accuracy of administrative database for pancreatic cancer (PC) have not been reported. We aimed to identify accuracy of NHI database regarding PC classified by international classification of disease (ICD)-10 codes.

AIM

To identify the accuracy and usefulness of administrative database in PC and the accurate ICD codes for PC with location.

METHODS

Study and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital. Cases of PC were identified in NHI database by international classification of diseases, 10th revision edition (ICD-10 codes) supported with V codes. V code is issued by medical doctors for covering 95% of medical cost by Korean government. According to pathologic reports, definite or possible diagnoses were defined using medical records, images, and pathology.

RESULTS

A total of 1846 cases with PC and controls were collected. Among PC, only 410 (22.2%) cases were identified as specific cancer sites including head in 234 (12.7%) cases, tail in 104 (5.6%) cases and body in 72 (3.9%) cases. Among PC, 910 (49.3%) cases were diagnosed by definite criteria. Most of these were adenocarcinoma (98.0%). The rates of definite diagnosis of PC were highest in head (70.1%) followed by body (47.2%) and tail (43.3%). False-positive cases were pancreatic cystic neoplasm and metastasis to the pancreas. In terms of the overall diagnosis of PC, sensitivity, specificity, positive predictive value, and negative predictive value were 99.95%, 98.72%, 98.70%, and 99.95%, respectively. Diagnostic accuracy was similar both in terms of diagnostic criteria and tumor locations.

CONCLUSION

Korean NHI claims database collected according to ICD-10 code with V code for PC showed good accuracy.

Keywords: Korean national health insurance, Accuracy, Pancreatic cancer, International classification of disease, Sensitivity, Specificity

Core tip: International classification of diseases, 10th revision edition (ICD-10 codes) of pancreatic cancer in an administrative database are acceptable for use for population-based large-cohort studies. To enhance the diagnostic accuracy, we recommend patient identification by the ICD-10 code with tumor location information.