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Public Health Reports: Improving an Administrative Case Definition for Longitudinal Surveillance of Sickle Cell Disease

In a recent article in Public Health Reports, Dr. Angela B. Snyder and Ms. Mei Zhou of Georgia State University, Mr. Rodney Theodore of Children’s Healthcare of Atlanta, Drs. Maa-Ohui Quarmyne and Peter A. Lane of Emory University School of Medicine & Sickle Cell Disease Program, and Dr. James Eckman of Emory University School of Medicine sought to improve an administrative case definition for sickle cell disease (SCD) to aid in longitudinal surveillance.

Data was collected from 3 administrative data sets on 1998 patients aged 0-21 in Georgia who had more than 1 encounter in which an SCD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code was recorded. This data was compared with data from a laboratory and medical record review. Performance, including specificity, sensitivity, negative predictive value (NVP), and positive predictive value (PPV), of case definitions that differed by number and type of SCD-coded encounters were assessed, in addition to SCD-associated treatments, procedures, and complications and number and length of surveillance. Correct diagnoses for patients who were incorrectly coded as having SCD was also identified.

Results indicated that the SCD case definition of more than 3 SCD-coded encounters in 5 years simplified and substantially improved the sensitivity and NPV of the original administrative case definition developed for 5-year, state-based surveillance, while maintaining a similar positive predictive value and specificity. The authors ultimately supported an administrative case definition that specifies more 3 ICD-9-CM–coded encounters to identify SCD with a high degree of accuracy in pediatric patients. 

Full article. 

Public Health Reports (PHR) is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. The journal is peer-reviewed and publishes original research, reviews, and commentaries in the areas of public health practice and methodology, original research, public health law, and teaching at schools and programs of public health schools and teaching. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public HealthPHR’s mission is to facilitate the movement of science into public health practice and policy to positively affect the health and wellness of the American public. 

Visit Public Health Reports for more information about the journal.