Validation Study of the Claims-Based Algorithm Using the International Classification of Diseases Codes to Identify Patients With Coronavirus Disease in Japan From 2020 to 2022: The VENUS Study

Abstract

Purpose: We validated claims-based algorithms using the International Classification of Diseases, Tenth Revision (ICD-10) to identify patients with the first-ever coronavirus disease (COVID-19) onset between May 2020 and August 2022. Methods: The study cohort was comprised of residents of one municipality enrolled in a public insurance program. This study used data provided by the municipality, including residents' insurer-based medical claims data linked to the Health Center Real-time Information-Sharing System (HER-SYS). The HER-SYS data included positive results from COVID-19 tests and were used as reference standards. Claims-based algorithms #1 and #2 were U07.1, B34.2, with and without suspicious diagnoses, respectively. Claims-based algorithms #3 and #4 were U07.1 with and without suspicious diagnoses, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each algorithm. Results: The study cohort included 165 038 residents, including 13 402 residents were the reference standard. For the entire period, the sensitivity, specificity, PPV, and NPV were 55.7% (95% confidence interval: 54.8%–56.5%), 65.4% (65.2%–65.6%), 11.5% (11.3%–11.8%), and 98.9% (98.8%–99.0%) for Algorithm #1, and 67.0% (66.2%–67.8%), 88.1% (87.9%–88.3%), 31.6% (31.1%–32.2%), and 97.8% (97.7%–97.8%) for Algorithm #2, and 52.9% (52.0%–53.7%), 67.1% (66.9%–67.3%), 11.5% (11.2%–11.8%), and 98.3% (98.3%–98.4%) for Algorithm #3, 62.6% (61.8%–63.4%), 88.5% (88.3%–88.7%), 30.9% (30.3%–31.4%), and 97.3% (97.2%–97.4%) for Algorithm #4, respectively. Conclusions: Our study showed that the validity of claims-based algorithms consisting of COVID-19-related ICD-10 codes to identify patients with first-onset COVID-19 is limited.