Abstract:
AIMS:To assess the validity of the diagnostic codes relating to diabetic foot ulcer (DFU) in the electronic medical records of a large integrated care provider and to assess the prevalence of DFU among its members. MATERIALS AND METHODS:Data were obtained from the diabetes registry of Maccabi Healthcare Services (MHS), a 2.1-million-member sick-fund in Israel, which included 125 665 patients in 2015. We randomly selected and reviewed ~400 patient files from each of the following categories during study period: (1) had a diagnostic code of DFU; (2) had a diagnostic code, or clinical condition suggestive of DFU including: leg-ulcer, amputation, DFU in quartiles proximate to 2015 or abnormality reported by nurse; (3) patients at high risk for DFU (age > 35 and one of the following: peripheral artery disease, neuropathy, DFU during 2011-2014, eGFR<30 mL/min/m2 or foot deformity). The patients' charts were reviewed by study physicians, and DFU was validated or refuted. RESULTS:Relying upon diagnostic codes entered by physicians, the positive predictive value (PPV) was 73.1% (95% CI 67.6-78.2), and the sensitivity was 48.2% (95% CI 45.8-50.7%). The PPV of the diagnostic codes listed by podiatrists were significantly lower, while that of codes listed by nurses was higher but with lower sensitivity. The estimated annual prevalence of DFU in the diabetes registry of MHS was 1.2% (95%CI 1.0-1.5%). CONCLUSIONS:Diagnostic codes alone cannot be used reliably to create a DFU registry. Nevertheless, the data collected provide an estimate of the prevalence of DFU among patients included in the MHS diabetes registry.
journal_name
Diabetes Metab Res Revjournal_title
Diabetes/metabolism research and reviewsauthors
Cahn A,Altaras T,Agami T,Liran O,Touaty CE,Drahy M,Pollack R,Raz I,Chodick G,Zucker Idoi
10.1002/dmrr.3094subject
Has Abstractpub_date
2019-02-01 00:00:00pages
e3094issue
2eissn
1520-7552issn
1520-7560journal_volume
35pub_type
杂志文章abstract:BACKGROUND:To evaluate the economic aspects of diabetic foot care in a multidisciplinary setting. METHOD:A review of the English language literature, published from 1966 to November 2005. RESULTS:The results of available studies on the cost-of-illness of diabetic foot problems are difficult to compare. Nevertheless t...
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