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Table 2 Accuracy of disease detection through drugs prescription among hospitalized patients (N = 108,915)

From: Disease identification based on ambulatory drugs dispensation and in-hospital ICD-10 diagnoses: a comparison

Morbidity group Diagnosed condition Screened by drug Sensitivity Specificity Kc a K0 a K1 a Useb
With K C > 0.4         
Transplant 467 601 0.82 1.00 0.71 (0.63) (0.82) M, C, R
Diabetes mellitus 8,171 8,114 0.71 0.98 0.70 (0.70) (0.69) M, C, R
HIV disease 413 372 0.60 1.00 0.63 (0.67) (0.60) M, C, R
Hypertensive disease 22,307 34,680 0.77 0.80 0.49 (0.37) (0.67)  
Alternative refinement:         
Hypertension and heart failure 23,886 35,954 0.78 0.80 0.51 (0.39) (0.68) M, C, R
Thyroid disorders 3,179 2,993 0.40 0.98 0.40 (0.41) (0.38) M, C, R
With K 0 >0.4 and alternatives to pharmacological treatment     
Multiple sclerosis 444 115 0.20 1.00 (0.32) 0.78 (0.20) C, R
Abuse of alcohol 4,584 619 0.09 1.00 (0.16) 0.68 (0.09) C, R
Ischemic heart disease 10,691 4,537 0.26 0.98 (0.33) 0.56 (0.23) C, R
Conduction disorders and cardiac arrhythmias 8,297 2,512 0.18 0.99 (0.26) 0.56 (0.16) C, R
Malignant neoplasms 7,528 3,757 0.29 0.98 (0.36) 0.54 (0.26) C, R
Abuse of opioid 1,131 45 0.02 1.00 (0.04) 0.51 (0.02) C, R
Hepatitis B or C 885 90 0.05 1.00 (0.09) 0.50 (0.05) C, R
Non-nutritional anaemia 6,114 642 0.05 1.00 (0.08) 0.41 (0.04)  
Including those of end stage renal disease and due to chemotherapy 8,868 642 0.05 1.00 (0.08) 0.63 (0.04) C, R
With K 1 > 0.4     
Obvious under-coded diagnoses     
Glaucoma 431 4167 0.70 0.96 (0.13) (0.07) 0.69 M, C, R
Hyperlipidemia 8,052 18,050 0.71 0.88 (0.38) (0.26) 0.65 M, C, R
Functional digestive disorders 1,275 27,846 0.63 0.75 (0.04) (0.02) 0.50 c
Hyperplasia of prostate 2,793 7,816 0.52 0.94 (0.26) (0.17) 0.49 M, C, R
Osteoporosis 2,443 4,765 0.49 0.97 (0.31) (0.23) 0.46 M, C, R
Signs of under-coded diagnoses     
Mood disorders 6,649 19,624 0.68 0.85 (0.29) (0.18) 0.61 M, C, R
Reactive airway disease 6,045 11,960 0.58 0.92 (0.36) (0.25) 0.53 M, C, R
Alzheimer’s disease 844 1,307 0.48 0.99 (0.37) (0.31) 0.48 M, C, R
Crohn’s disease and ulcerative colitis 433 824 0.48 0.99 (0.33) (0.25) 0.48 M, C, R
Multiple diagnoses indication of tracer drugs  
Parkinson’s disease 914 2,219 0.67 0.99 (0.38) (0.27) 0.66  
Alternative refinement         
w/o anti-psychotic 914 1,739 0.65 0.99 0.44 (0.37) 0.64 M, C, R
Schizophrenia and other disorders 1,911 6,439 0.67 0.95 (0.29) (0.18) 0.64  
Alternative refinement         
w/o anti-cholinesterasic 1,911 5,985 0.66 0.96 (0.30) (0.20) 0.64 C, R
Epilepsy 1,656 5,727 0.54 0.96 (0.23) (0.14) 0.52  
Alternative refinement         
w/o chronic pain drugs 1,656 4,260 0.52 0.97 (0.28) (0.19) 0.50 C, R
Prophylactic treatment         
Thrombo-embolic risk or disease 6,122 29,427 0.72 0.76 (0.18) (0.10) 0.61  
if including thrombogenic cardiac diseases 17,804 29,427 0.73 0.82 0.45 (0.33) 0.63 M, C, R
Diseases of esophagus, peptic ulcer 3,805 31,331 0.72 0.73 (0.11) (0.05) 0.60 c
With all K values < 0.4    
Acute diseases with time limited treatment, minor or rare conditions as inpatients  
Migraine 601 1,771 0.29 0.99 (0.14) (0.09) 0.28 C
Vertigo 623 2,084 0.29 0.98 (0.13) (0.08) 0.28 c
Bacterial infection or septicemia 10,433 41,704 0.58 0.64 (0.13) (0.05) 0.32 c
Eye inflammation 467 6,827 0.33 0.94 (0.04) (0.02) 0.29 C
Dermatitis 1,091 14,461 0.33 0.87 (0.03) (0.02) 0.23 C , R
Mycosis 988 16,971 0.36 0.85 (0.03) (0.01) 0.25 C
Other diseases of upper respiratory tract – allergy 466 9,917 0.31 0.91 (0.02) (0.01) 0.24 C
Disorders of external ear 71 2,070 0.27 0.98 (0.02) (0.01) 0.25 C
Parasitosis 61 1,984 0.26 0.98 (0.01) (0.01) 0.25 C
Other acute upper respiratory infections 856 32,259 0.50 0.71 (0.01) (0.01) 0.28 c
Acne 72 2,774 0.25 0.97 (0.01) (0.01) 0.23 C , R
Psoriasis 466 1,188 0.35 0.99 (0.19) (0.13) 0.34 C , R
Gout 659 2,126 0.39 0.98 (0.18) (0.12) 0.38 C , R
Female inflammatory diseases 864 6,331 0.25 0.94 (0.05) (0.03) 0.20  
Conjonctivitis 114 6,458 0.24 0.94 (0.01) (0.00) 0.19  
Hemorrhoids 1,188 3,048 0.19 0.97 (0.10) (0.06) 0.16  
Skin or subcutaneous infections 695 9,565 0.21 0.91 (0.02) (0.01) 0.14  
Paludism 28 444 0.14 1.00 0.02 0.01 0.14 28 444 0.14 1.00 (0.02) (0.01) 0.14  
Intestinal infectious diseases 1,608 7,131 0.19 0.94 (0.06) (0.03) 0.13  
Viral diseases 1,261 1,801 0.15 0.98 (0.11) (0.09) 0.13  
Influenza 177 74 0.00 0.00 (0.00)    
Multiple diagnoses indication of tracer drugs   
Inflammatory polyarthritis and connective tissue disorders 1,321 6,526 0.39 0.94 (0.12) (0.07) 0.35 c
Anaemias – nutritional 3,122 11,845 0.31 0.90 (0.10) (0.06) 0.23 c
Other mental and behavioral disorders 7,852 28,126 0.54 0.76 (0.16) (0.08) 0.37 c
Pain 12,341 66,022 0.73 0.41 (0.07) (0.02) 0.31 c
Severe pain d 12,341 7,429 0.16 0.92 (0.13) (0.13) 0.07  
Prophylaxis treatment    
Tuberculosis 216 226 0.31 1.00 (0.30) (0.29) 0.30  
Active tuberculosis 216 82 0.25 1.00 (0.36) (0.66) 0.25 C, R
Alternatives to pharmacological treatment   
Neutropenia 468 369 0.18 1.00 (0.21) 0.26 (0.17)  
Extended to prophylaxis of myelosuppressive chemotherapy 1,452 369 0.16 1.00 (0.25) 0.63 (0.16) C, R
Obesity 6,106 639 0.03 1.00 (0.05) 0.23 (0.02) c
Other endocrine nutritional and metabolic diseases 8,393 160 0.00 1.00 (0.01) 0.19 (0.00)  
Hemorrhagic risk or disease 1,434 756 0.05 0.99 (0.07) 0.09 (0.05)  
Poisonings 1,061 309 0.00 1.00 (0.00) 0.00 (0.00)  
Heart failure 3,166 94 0.00 1.00 (0.00) 0.02 (0.00)  
Alternative refinement: see hypertension/heart failure above    
Abuse of tobacco 7,062 14 0.00 1.00 (0.00) 0.08 (0.00)  
  1. aKappa values, not used as judgment criteria are in parenthesis.
  2. bContext of use: morbidity indicator (M), ambulatory costs control (C), insurers’ risk adjustment (R) only for chronic conditions.
  3. cAppropriateness of pharmacologic treatment uncertain, prone to practice variations.
  4. dStrong opioids.