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Table 1 Characteristics of studies included and summary of measures reported in validation studiesa

From: Validity of administrative data in recording sepsis: a systematic review

Authors, country, year [ref]

Sample population

Data years

Type of administrative database

Study size (n)

ICD version

Diagnostic coding field position

Reference/gold standard

Sn

Sp

PPV

NPV

Cevasco et al., USA, 2011 [19]

General surgical

2003 to 2007

Population-based, inpatient Veterans Affairs hospital

112

ICD-9-CM

Secondary

Medical chart review

53%

General surgical

2005 to 2007

Population-based, inpatient community hospital

164

ICD-9-CM

Secondary

Medical chart review

41%

Gedeborg et al., Sweden, 2007 [20]

ICU-specific

1994 to 1999

Population-based, inpatient

4,181

ICD-9b

Principal, secondary

ICU database

45.7%

97.5%

45.9%

97.5%

ICU-specific

1994 to 1999

Population-based, inpatient

3,434

ICD-10b

Principal, secondary

ICU database

52.5%

92.6%

28.0%

97.3%

ICU-specific and DI

1994 to 1999

Population-based, inpatient

4,181

ICD-9b

Principal, secondary

ICU database

17.2%

99.4%

56.1%

96.3%

ICU-specific and DI

1994 to 1999

Population-based, inpatient

3,434

ICD-10b

Principal, secondary

ICU database

20.1%

98.4%

40.9%

95.7%

ICU-specific

1994 to 1999

Population-based, inpatient

45

ICD-9b ICD-10b

Principal, secondary

Sepsis clinical trial patients

42.2%

95.5%

7.4%

99.5%

ICU-specific

1994 to 1999

Inpatient intensivist-coded ICU database

45

ICD-9b ICD-10b

Principal, secondary

Sepsis clinical trial patients

51.5%

92.6%

5.6%

99.6%

ICU-specific

1994 to 1999

Population-based, inpatient

4,181

ICD-9c

Principal, secondary

ICU database

43.0%

98.0%

49.7%

97.4%

ICU-specific

1994 to 1999

Population-based, inpatient

3,434

ICD-10c

Principal, secondary

ICU database

43.0%

95.6%

ICU-specific

1994 to 1999

Population-based, inpatient

4,181

ICD-9b

Principal

ICU database

31.7%

99.2%

63.4%

97.0%

ICU-specific

1994 to 1999

Population-based, inpatient

3,434

ICD-10b

Principal

ICU database

21.8%

97.9%

36.4%

95.8%

ICU-specific: CAS

1994 to 1999

Population-based, inpatient

4,181

ICD-9b

Principal

ICU database

51.1%

99.4%

66.7%

98.9%

ICU-specific CAS

1994 to 1999

Population-based, inpatient

3,434

ICD-10b

Principal

ICU database

31.8%

99.0%

41.5%

98.3%

ICU-specific CAP and DI

1994 to 1999

Population-based, inpatient

3,434

ICD-9b

Principal

ICU database

19.1%

99.8%

64.3%

98.2%

ICU-specific CAS and DI

1994 to 1999

Population-based, inpatient

3,434

ICD-10b

Principal

ICU database

17.6%

99.4%

42.8%

97.9%

ICU-specific CAS

1994 to 1999

Population-based, inpatient

3,434

ICD-9c

Principal

ICU database

47.9%

99.5%

70.3%

98.8%

ICU-specific CAS

1994 to 1999

Population-based, inpatient

3,434

ICD-10c

Principal

ICU database

27.1%

99.0%

39.7%

98.2%

ICU-specific CAS

1994 to 1999

Population-based, inpatient

45

ICD-9c ICD-10c

Principal

Sepsis clinical trial patients

46.9%

97.4%

9.9%

99.7%

ICU-specific CAS

1994 to 1999

Inpatient intensivist-coded ICU database

45

ICD-9c ICD-10c

Principal

Sepsis clinical trial patients

31.2%

98.5%

10.9%

99.6%

Grijalva et al., USA, 2008 [21]

Rheumatoid arthritis

1995 to 2004

Inpatient database

45

ICD-9-CM

Principal, secondary

Medical chart review

80%

Ibrahim et al., Australia, 2012 [22]

General ICU

2000 to 2006

Inpatient database

1,645

ICD-10-AM

Principal

ICU database

44.1%

98.9%

88.2%

90.6%

General ICU

2000 to 2006

Inpatient database

45

ICD-10-AM

Principal

ICU database

16.5%

99.8%

93.9%

86.8%

Iwashyna et al., USA, 2014 [12]

General

2009 to 2010

Population-based, inpatient

111

ICD-9-CM Angus

All

Medical chart review

50.3%

96.3%

70.7%

91.5%

General

2009 to 2010

Population-based, inpatient

111

ICD-9-CM Explicit

All

Medical chart review

9.3%

100%

100%

86.0%

General

2009 to 2010

Population-based, inpatient

111

ICD-9-CM Martin

All

Medical chart review

16.8%

99.8%

97.6%

87.0%

Lawson et al., USA, 2012 [23]

General surgical

2005 to 2008

Population-based claims data

13,410

ICD-9-CM

All

ACS-NSQIP inpatient surgical database

46.3%

94.0%

Madsen et al., Denmark, 1998 [24]

General

1994

Population-based, inpatient

471

ICD-10, Danish version

Unknown

Bacteraemia database

5.9%

21.7%

Ollendorf et al., USA, 2002 [25]

Severe sepsis clinical trial patients

No dates given

Population-based, inpatient claims

122

ICD-9-CM

All

Severe sepsis clinical trial patients

75.4%

Quan et al., Canada, 2013 [26]

General surgical

2007 to 2008

Population-based, inpatient

117

ICD-10

Secondary

Medical chart review

9.8%

General surgical

2007 to 2008

Population-based, inpatient

34

ICD-10

Secondary

Medical chart review

12.5%

Ramanathan et al., USA, 2014 [27]

Surgical patients

2012 to 2013

Surgical inpatient

243

ICD-9-CM

All

Medical chart review

82.3%

78.3%

91.1%

62.1%

Schneeweiss et al., USA, 2007 [28]

General

2001 to 2004

Population-based, inpatient

158

ICD-9-CM

Principal

Medical chart review

91%

Whittaker et al., USA, 2013 [29]

ED admitted inpatients

2005 to 2009

Population-based, inpatient

1,735

ICD-9 (severe)

All

Medical chart review

20.5%

ED admitted inpatients

2005 to 2009

Population-based, inpatient

1,735

ICD-9 (severe)

All

Medical chart review

47.2% (Angus)

ED admitted inpatients

2005 to 2009

Population-based, inpatient

321

ICD-9 (shock)

All

Medical chart review

49.5%

ED admitted inpatients

2005 to 2009

Population-based, inpatient

321

ICD-9 (shock)

All

Medical chart review

42.4%

ED admitted inpatients

2005 to 2009

Population-based, inpatient

321

ICD-9 (shock)

All

Medical chart review

75.1% (Angus)

  1. aCAS, Community-acquired sepsis (intensive care unit (ICU) admission within 48 hours); DI, Department of Infectious Disease patients; ICD, International Classification of Diseases; AM, Australian Modification; CM, Clinical Modification; ACS-NSQIP, American College of Surgeons National Surgical Quality Improvement Program; ED, Emergency Department; NPV, Negative predictive value; PPV, Positive predictive value; Sn, Sensitivity; Sp, Specificity. bSepsis wide criteria codes. cSepsis narrow criteria codes.