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Automated identification of miscoded and misclassified cases of diabetes from computer records.

Sadek, AR, van Vlymen, J, Khunti, K and de Lusignan, S (2012) Automated identification of miscoded and misclassified cases of diabetes from computer records. Diabet Med, 29 (3). 410 - 414. ISSN 0742-3071

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Aims:  To develop a computer processable algorithm, capable of running automated searches of routine data that flag miscoded and misclassified cases of diabetes for subsequent clinical review. Method: Anonymized computer data from the Quality Improvement in Chronic Kidney Disease (QICKD) trial (n = 942 031) were analysed using a binary method to assess the accuracy of data on diabetes diagnosis. Diagnostic codes were processed and stratified into: definite, probable and possible diagnosis of Type 1 or Type 2 diabetes. Diagnostic accuracy was improved by using prescription compatibility and temporally sequenced anthropomorphic and biochemical data. Bayesian false detection rate analysis was used to compare findings with those of an entirely independent and more complex manual sort of the first round QICKD study data (n = 760 588). Results:  The prevalence of definite diagnosis of Type 1 diabetes and Type 2 diabetes were 0.32% and 3.27% respectively when using the binary search method. Up to 35% of Type 1 diabetes and 0.1% of Type 2 diabetes were miscoded or misclassified on the basis of age/BMI and coding. False detection rate analysis demonstrated a close correlation between the new method and the published hand-crafted sort. Both methods had the highest false detection rate values when coding, therapeutic, anthropomorphic and biochemical filters were used (up to 90% for the new and 75% for the hand-crafted search method). Conclusions:  A simple computerized algorithm achieves very similar results to more complex search strategies to identify miscoded and misclassified cases of both Type 1 diabetes and Type 2 diabetes. It has the potential to be used as an automated audit instrument to improve quality of diabetes diagnosis.

Item Type: Article
Divisions : Faculty of Business, Economics and Law > Health Care Management and Policy
Authors :
Date : March 2012
Identification Number : 10.1111/j.1464-5491.2011.03457.x
Additional Information : ©2011 The Authors / ©2011 Diabetes UK. The definitive version is available at
Depositing User : Symplectic Elements
Date Deposited : 20 Aug 2012 15:05
Last Modified : 23 Sep 2013 18:45

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