accuracy of syndrome definitions based on diagnoses in physician claims综合症的定义根据医生诊断的准确性.pdfVIP

Cadieux et al. BMC Public Health 2011, 11:17 /1471-2458/11/17 RESEARCH ARTICLE Open Access Accuracy of syndrome definitions based on diagnoses in physician claims 1* 1,2 3 4 1 Geneviève Cadieux , David L Buckeridge , André Jacques , Michael Libman , Nandini Dendukuri , Robyn Tamblyn1,4 Abstract Background: Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study’s objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics. Methods: We selected a random sample of 3,600 community-based primary care physicians who practiced in the fee-for-service system in the province of Quebec, Canada in 2005-2007. We randomly selected 10 visits per physician from their claims, stratifying on syndrome type and presence, diagnosis, and month. Double-blinded chart reviews were conducted by telephone with consenting physicians to obtain information on patient diagnoses for each sampled visit. The sensitivity, specificity, and positive predictive value (PPV) of physician claims were estimated by comparison to chart review. Results: 1,098 (30.5%) physicians completed the chart review. A chart entry on the date of the corresponding claim was found for 10,529 (95.9%) visits. The sensitivity of syndrome definitions based on diagnostic codes in physician claims was low, ranging from 0.11 (fever) to 0.44 (respiratory), the specificity was high, and the