Abstract
Purpose :
Clinical registries and administrative claims data are utilized in the ocular oncology literature, however the accuracy of claims data for capturing ocular neoplasm diagnoses is unclear. This study evaluated the predictive value of International Classification of Diseases, 9th Revision (ICD-9) billing codes for identifying ocular oncology diagnoses.
Methods :
Population-based retrospective cohort study of all Olmsted County, Minnesota residents diagnosed with any ocular neoplasm. The medical records of all individuals with any ocular neoplasm-related ICD-9 code from January 1, 2006 to December 31, 2015 were reviewed. Diagnoses with ≥5 cases confirmed via medical record review were compared to their corresponding ICD-9 codes. Main outcome measures included positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity of ICD-9 codes.
Results :
Among 3,932 subjects with ≥1 ocular neoplasm-related ICD-9 code, 21 diagnoses met study criteria. The most frequent intraocular, extraocular/orbital, and ocular surface diagnoses were choroidal nevus (n=824), epidermal inclusion cyst (n=263), and conjunctival nevus (n=74), respectively. PPVs ranged from 1.2% to 73.8%, NPVs from 96.9% to 100%, sensitivity from 0% to 100%, and specificity from 85.7% to 100%. Among benign neoplasms, PPV ranged from 1.2% (dermoid cyst) to 61.6% (choroidal nevus). Among malignant neoplasms, PPV ranged from 0% to 73.8%: ocular surface squamous neoplasia (PPV: 0%), choroidal melanoma (PPV: 25.0%), eyelid squamous cell carcinoma (PPV: 46.7%), and eyelid basal cell carcinoma (PPV: 73.8%).
Conclusions :
The predictive value of ocular neoplasm-related ICD-9 billing codes varied widely in this cohort. These findings suggest that the use of ocular neoplasm-related claims data alone may overestimate the true number of ocular oncology diagnoses. Ocular oncology studies utilizing claims data to identify cases should be interpreted with caution given the variable predictive values of ocular neoplasm-related ICD-9 codes.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.