Accurate diagnosis of bullous pemphigoid requires multiple health care visits
Leisti, Päivi; Pankakoski, Anna; Jokelainen, Jari; Varpuluoma, Outi; Huilaja, Laura; Panelius, Jaana; Tasanen, Kaisa (2023-11-27)
Frontiers Research Foundation
27.11.2023
Leisti P, Pankakoski A, Jokelainen J, Varpuluoma O, Huilaja L, Panelius J and Tasanen K (2023) Accurate diagnosis of bullous pemphigoid requires multiple health care visits. Front. Immunol. 14:1281302. doi: 10.3389/fimmu.2023.1281302.
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© 2023 Leisti, Pankakoski, Jokelainen, Varpuluoma, Huilaja, Panelius and Tasanen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
https://creativecommons.org/licenses/by/4.0/
© 2023 Leisti, Pankakoski, Jokelainen, Varpuluoma, Huilaja, Panelius and Tasanen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202312213999
https://urn.fi/URN:NBN:fi:oulu-202312213999
Tiivistelmä
Abstract
Introduction:
Accurate use of diagnostic codes is crucial for epidemiological and genetic research based on electronic health record (EHR) data.
Methods:
This retrospective study validated the International Classification of Diseases (ICD)-10 diagnostic code L12.0 for bullous pemphigoid (BP) using EHR data from two Finnish university hospitals. We found 1225 subjects with at least one EHR entry of L12.0 between 2009 and 2019. BP diagnosis was based on clinical findings characteristic of BP and positive findings on direct immunofluorescence (DIF), BP180-NC16A enzyme-linked immunosorbent assay (ELISA) or indirect immunofluorescence (IIF) assay.
Results:
True BP was found in 901 patients; the positive predictive value (PPV) for L12.0 was 73.6% (95% CI 71.0-76.0). L12.0 was more accurately registered in dermatology units than any specialized health care units (p<0.001). Including patients with multiple L12.0 registrations (≥3), increased the accuracy of the L12.0 code in both dermatology units and other settings.
Discussion:
One diagnostic code of L12.0 is not enough to recognize BP in a large epidemiological data set; including only L12.0 registered in dermatology units and excluding cases with <3 L12.0 record entries markedly increases the PPV of BP diagnosis.
Introduction:
Accurate use of diagnostic codes is crucial for epidemiological and genetic research based on electronic health record (EHR) data.
Methods:
This retrospective study validated the International Classification of Diseases (ICD)-10 diagnostic code L12.0 for bullous pemphigoid (BP) using EHR data from two Finnish university hospitals. We found 1225 subjects with at least one EHR entry of L12.0 between 2009 and 2019. BP diagnosis was based on clinical findings characteristic of BP and positive findings on direct immunofluorescence (DIF), BP180-NC16A enzyme-linked immunosorbent assay (ELISA) or indirect immunofluorescence (IIF) assay.
Results:
True BP was found in 901 patients; the positive predictive value (PPV) for L12.0 was 73.6% (95% CI 71.0-76.0). L12.0 was more accurately registered in dermatology units than any specialized health care units (p<0.001). Including patients with multiple L12.0 registrations (≥3), increased the accuracy of the L12.0 code in both dermatology units and other settings.
Discussion:
One diagnostic code of L12.0 is not enough to recognize BP in a large epidemiological data set; including only L12.0 registered in dermatology units and excluding cases with <3 L12.0 record entries markedly increases the PPV of BP diagnosis.
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