학술논문

Administrative Coding in Electronic Health Care Record‐Based Research of NAFLD: An Expert Panel Consensus Statement
Document Type
article
Source
Hepatology. 74(1)
Subject
Patient Safety
Clinical Research
Good Health and Well Being
Biomedical Research
Clinical Coding
Consensus
Electronic Health Records
Humans
Non-alcoholic Fatty Liver Disease
Reference Standards
Medical Biochemistry and Metabolomics
Clinical Sciences
Immunology
Gastroenterology & Hepatology
Language
Abstract
Background and aimsElectronic health record (EHR)-based research allows the capture of large amounts of data, which is necessary in NAFLD, where the risk of clinical liver outcomes is generally low. The lack of consensus on which International Classification of Diseases (ICD) codes should be used as exposures and outcomes limits comparability and generalizability of results across studies. We aimed to establish consensus among a panel of experts on ICD codes that could become the reference standard and provide guidance around common methodological issues.Approach and resultsResearchers with an interest in EHR-based NAFLD research were invited to collectively define which administrative codes are most appropriate for documenting exposures and outcomes. We used a modified Delphi approach to reach consensus on several commonly encountered methodological challenges in the field. After two rounds of revision, a high level of agreement (>67%) was reached on all items considered. Full consensus was achieved on a comprehensive list of administrative codes to be considered for inclusion and exclusion criteria in defining exposures and outcomes in EHR-based NAFLD research. We also provide suggestions on how to approach commonly encountered methodological issues and identify areas for future research.ConclusionsThis expert panel consensus statement can help harmonize and improve generalizability of EHR-based NAFLD research.