Diagnostic accuracy of algorithms to define incident and second hip fractures: A Taiwan validation study
Journal
Journal of the Formosan Medical Association
Date Issued
2023
Author(s)
Yu, Ping-Ying
Li, Chung-Yi
Hung, Chih-Chien
Tai, Ta-Wei
Hwang, Jawl-Shan
Lin, Sung-Yen
Wu, Chih-Hsing
Liao, Ling-Chiao
Chuang, Chin-Ju
Wu, Chiu-Yi
Chang, Cheng-Ying
MING-TSUNG LEE
Chen, Chung-Hwan
Wang, Chen-Yu
Abstract
Background: Previous epidemiological researchers have used various algorithms to identify a second hip fracture; however, there has been no validation of these algorithms to date. This study aimed to verify existing algorithms for identifying second hip fracture under the International Classification of Diseases diagnostic coding systems. Furthermore, we examined the validity of two newly proposed algorithms that integrated the concept of periprosthetic fractures and laterality of the ICD-10 coding system.
Methods: Claims data of patients hospitalized for hip fracture from National Taiwan University Hospitals between 2007 and 2020 were retrieved. Hip fracture was confirmed by 2 orthopaedic surgeons with medical records and imaging data as gold standards. The validity of 9 existing and 2 newly proposed algorithms for identifying second hip fracture was evaluated.
Results: The positive predictive value (PPV) range between 84% and 90% in existing algorithms for identifying second hip fractures. Noteworthy, the longer time interval for discrimination resulted in slightly increased PPV (from 87% to 90%), while decreased sensitivity noticeably (from 87% to 72%). When considering the information about periprosthetic fracture, the PPV increased to 91% without diminished sensitivity. The PPV of the newly proposed ICD-10-specific algorithm was 100%.
Conclusion: Algorithms integrated clinical insights of periprosthetic fractures and laterality concept of ICD-10 coding system provided satisfactory validity and help precisely define second hip fracture in future database research.
Subjects
Diagnostic accuracy
Hip fractures
International classification of diseases
Periprosthetic fracture
Validity
Type
journal article