ReportPotential misclassification of patients with psoriasis in electronic databases
Section snippets
Methods
This was a retrospective study using the data resources of the Rochester Epidemiology Project (REP). As described previously, REP is a centralized medical records linkage system that encompasses all health care delivered to residents of Olmsted County, Minnesota.12 All health care providers in this county use a unit medical record system whereby all medical information on each individual is accumulated within a single dossier. Furthermore, detailed indices containing all clinical, surgical, and
Results
We identified a total of 2556 potential patients with diagnostic codes consistent with psoriasis between 1976 and 2000. After manual screening of the medical records from all health care providers, 1458 (57.0%) patients with psoriasis were confirmed as having incident psoriasis. Of the remaining 1098 patients, 62.4% had diagnoses other than psoriasis (eg, parapsoriasis, pityriasis rosea, psoriasiform dermatitis) and 37.6% had prevalent conditions (ie, psoriasis before study time frame or moved
Discussion
In this study, we report on the validity of psoriasis diagnostic codes in an electronic medical record database. Both the type and frequency of psoriasis codes influence the validity of identification of patients with psoriasis. The PPV remains as high as 60% for a single psoriasis code in a 5-year time window, indicating that the relapsing and remitting disease course in psoriasis may challenge electronic identification of patients with psoriasis in database studies. These findings indicate
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Supported by an unrestricted research grant from Amgen Inc.
Disclosure: Dr Maradit Kremers has received consulting fees, speaking fees, and/or honoraria (less than $10,000) from Amgen. Drs Icen, Crowson, McEvoy, and Gabriel have no conflicts of interest to declare.