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Abstract:
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At a population level, use of ICD9 codes does not adequately distinguish pulmonary arterial hypertension (PAH) from pulmonary hypertension. Our objective is to develop and validate administrative algorithms for identification of PAH. We used Electronic Medical Records(EMR) of patients with ICD9 codes 416.0 or 416.8 with an outpatient visit at the University of Texas Medical Branch. Patients were broken into PAH and non-PAH groups based on EMR encounter diagnosis. Demographics, echocardiogram and right heart catheterization (RHC) results and PAH-specific therapies were collected. A diagnosis of PAH was determined by chart review of echocardiogram and RHC measurements. Weighted sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated for several administrative algorithms. The PPV of ICD9 codes alone was 9.3% whereas the combination of ICD9 codes with all variables (encounter diagnosis, RHC, echocardiogram and PAH therapies) had a PPV of 73.13% with a sensitivity of 76.56%, specificity of 97.11% and a NPV of 97.58%. The performance of algorithms to identify PAH patients improved with each new variable and were superior to ICD9 codes alone.
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