Abstract: Diagnostic codes are crucial for analyses of electronic health record (EHR) data but their accuracy and precision are often lacking. Although providers may enter precise diagnoses into progress notes, billing standards may limit the particularity of a diagnostic code. Variability also arises from the creation of multiple descriptions for a particular diagnostic code. We analyzed the variability of diagnostic codes before and after surgical pathology, the definitive diagnosis, for brain neoplasms. After pathology, the odds of more distinct diagnostic descriptions was 2.30 times higher (p=0.00358), entropy in diagnostic sequences was 2.26 times higher (p=0.0259) and entropy in diagnostic precision scores was 15.5 times higher (p=0.0324). Although diagnostic codes became more distinct after diagnostic pathology report, there was a paradoxical increase in the variability of the codes selected. Researchers need to be aware of the inconsistencies and lack of particularity in structured diagnostic coding despite the presence of a definitive diagnosis.
Learning Objective 1: Discuss the variability features in DX recordings after the accurate and precise information is already been records.
Learning Objective 2 (Optional): Cauton EHR data reusers about DX variability so it can be accounted during cohort selection tasks leading to secondary analyses.
Jose-Franck Diaz-Garelli (Presenter)
Brian Wells, WakeHealth
Caleb Yelton, WakeHealth
Roy Strowd, WakeHealth
Umit Topaloglu, WakeHealth