학술논문
Accuracy of diagnostic codes for prenatal opioid exposure and neonatal opioid withdrawal syndrome.
Document Type
Academic Journal
Author
Kuzniewicz MW; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Department of Pediatrics, University of California, San Francisco, CA, USA.; Department of Pediatrics, Kaiser Permanente Northern California, Oakland, CA, USA.; Campbell CI; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Li S; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Walsh EM; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. eileen.m.walsh@kp.org.; Croen LA; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Comer SD; Department of Psychiatry, Columbia University, New York, NY, USA.; Pimentel SD; Department of Statistics, University of California, Berkeley, CA, USA.; Hedderson M; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Sun LS; Department of Anesthesiology and Pediatrics, Columbia University, New York, NY, USA.
Source
Publisher: Nature Publishing Group Country of Publication: United States NLM ID: 8501884 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5543 (Electronic) Linking ISSN: 07438346 NLM ISO Abbreviation: J Perinatol Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: Determine the accuracy of diagnostic codes in identifying Prenatal Opioid Exposure (POE) and Neonatal Opioid Withdrawal Syndrome (NOWS).
Study Design: A cross-sectional study of 374,222 mother-infant dyads with delivery from 01/01/2010 to 12/31/2019. We ascertained maternal diagnostic codes for opioid use during pregnancy and infant diagnostic codes for drug exposure and withdrawal. We assessed sensitivity and positive predictive value (PPV) for POE and NOWS, defined using laboratory, pharmacy, and clinical data.
Results: Maternal codes had low sensitivity (36.4%) and PPV (34.7%) for POE. Infant codes for drug exposure were neither sensitive for POE (14%) nor NOWS (31.6%) and had low PPV. Codes for newborn withdrawal had low sensitivity (31.6%) for detecting NOWS, but high PPV (85%). Sensitivity improved (95.1%) for NOWS requiring pharmacologic treatment.
Conclusions: Diagnostic codes identify POE and NOWS poorly. Improved case identification would include pharmacy and laboratory results, and clearly defined criteria for evidence of withdrawal.
(© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Study Design: A cross-sectional study of 374,222 mother-infant dyads with delivery from 01/01/2010 to 12/31/2019. We ascertained maternal diagnostic codes for opioid use during pregnancy and infant diagnostic codes for drug exposure and withdrawal. We assessed sensitivity and positive predictive value (PPV) for POE and NOWS, defined using laboratory, pharmacy, and clinical data.
Results: Maternal codes had low sensitivity (36.4%) and PPV (34.7%) for POE. Infant codes for drug exposure were neither sensitive for POE (14%) nor NOWS (31.6%) and had low PPV. Codes for newborn withdrawal had low sensitivity (31.6%) for detecting NOWS, but high PPV (85%). Sensitivity improved (95.1%) for NOWS requiring pharmacologic treatment.
Conclusions: Diagnostic codes identify POE and NOWS poorly. Improved case identification would include pharmacy and laboratory results, and clearly defined criteria for evidence of withdrawal.
(© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)