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Study examines reliability of clinical and pathological diagnoses of Barrett's esophagus
Date:5/14/2009

D (pathology code) and an ICD (billing code) diagnosis, record review confirmed a diagnosis in 85.4 percent."

Patients and Methods

The study was conducted within the Kaiser Permanente, Northern California (KPNC) population, an integrated health services delivery organization. KPNC contains approximately 3.3 million members (approximately one third of the insured population in the region). Researchers identified all patients who received a Barrett's esophagus diagnosis between 1994 and 2005 according to ICD-9-CM codes 530.2 (Ulcer of esophagus) and 530.85 (Barrett's esophagus), which at KPNC were uniquely coded on reporting sheets as ''Barrett's esophagitis''at the time of an outpatient visit, and the SNOMED code M73330 (Barrett's esophagus). SNOMED codes are commonly used by pathology departments for assigning specific diagnoses.

This search identified 5,953 patients with a Barrett's esophagus diagnosis in the electronic database: 1,803 (30.3 percent) with only a SNOMED diagnosis, 1,630 (27.4 percent) with only an ICD-9-CM diagnosis, and 2,520 (42.3 percent) with both a SNOMED and an ICD-9-CM diagnosis. From the written and electronic medical records, researchers retrieved upper endoscopy and relevant pathology reports from a subset of 2,470 subjects (not the entire group due to resource limitations).

Reviews were performed by a board-certified gastroenterologist for 1,221 subjects and by professional medical record data abstractors (trained by the gastroenterologist and approximately a 10 percent subset reviewed by the gastroenterologist) for 1,249 subjects; the verification rates for both groups were comparable and are presented together in the study. The reviewer recorded whether each subject met the criteria for diagnosis, and if they did not meet the diagnosis why they were excluded or whether there was insufficient information to make an assignment. Standard descriptive statistics were calculated.

Researchers
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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