Table 3. Accuracy of disease detection through drugs prescription among hospitalized
patients (N= 108,915).
Morbidity group
Kca
K0a
K1a
Useb
1.00
0.98
1.00
0.80
0.71
0.70
0.63
0.49
(0.63)
(0.70)
(0.67)
(0.37)
(0.82)
(0.69)
(0.60)
(0.67)
M, C, R
M, C, R
M, C, R
0.78
0.80
0.51
(0.39)
(0.68)
M, C, R
0.40
0.98
0.40
(0.41)
(0.38)
M, C, R
Diagnosed
condition
Screened
by drug
Sensi- Specitivity ficity
467
8,171
413
22,307
601
8,114
372
34,680
0.82
0.71
0.60
0.77
23,886
35,954
3,179
2,993
With KC>0.4
Transplant
Diabetes mellitus
HIV disease
Hypertensive disease
Alternative refinement:
Hypertension and
heart failure
Thyroid disorders
With K0 >0.4 and alternatives to pharmacological treatment
Multiple sclerosis
Abuse of alcohol
Ischemic heart disease
Conduction disorders
and cardiac
arrhythmias
Malignant neoplasms
Abuse of opioid
Hepatitis B or C
Non-nutritional
anaemia
Including those of
end stage renal
disease and due to
chemotherapy
444
4,584
10,691
8,297
115
619
4,537
2,512
0.20
0.09
0.26
0.18
1.00
1.00
0.98
0.99
(0.32)
(0.16)
(0.33)
(0.26)
0.78
0.68
0.56
0.56
(0.20)
(0.09)
(0.23)
(0.16)
C, R
C, R
C, R
C, R
7,528
1,131
885
6,114
3,757
45
90
642
0.29
0.02
0.05
0.05
0.98
1.00
1.00
1.00
(0.36)
(0.04)
(0.09)
(0.08)
0.54
0.51
0.50
0.41
(0.26)
(0.02)
(0.05)
(0.04)
C, R
C, R
C, R
8,868
642
0.05
1.00
(0.08)
0.63
(0.04)
C, R
4167
18,050
27,846
0.70
0.71
0.63
0.96
0.88
0.75
(0.13)
(0.38)
(0.04)
(0.07)
(0.26)
(0.02)
0.69
0.65
0.50
M, C, R
M, C, R
7,816
0.52
0.94
(0.26)
(0.17)
0.49
M, C, R
4,765
0.49
0.97
(0.31)
(0.23)
0.46
M, C, R
19,624
11,960
0.68
0.58
0.85
0.92
(0.29)
(0.36)
(0.18)
(0.25)
0.61
0.53
M, C, R
M, C, R
1,307
824
0.48
0.48
0.99
0.99
(0.37)
(0.33)
(0.31)
(0.25)
0.48
0.48
M, C, R
M, C, R
With K1>0.4
Obvious under-coded diagnoses
Glaucoma
431
Hyperlipidemia
8,052
Functional digestive
1,275
disorders
Hyperplasia of
2,793
prostate
Osteoporosis
2,443
Signs of under-coded diagnoses
Mood disorders
6,649
Reactive airway
6,045
disease
Alzheimer's disease
844
Crohn's disease and
433
ulcerative colitis
c
1
Multiple diagnoses indication of tracer drugs
Parkinson’s disease
Alternative refinement
w/o anti-psychotic
Schizophrenia and
other disorders
Alternative refinement
w/o anticholinesterasic
Epilepsy
Alternative refinement
w/o chronic pain
drugs
Prophylactic treatment
Thrombo-embolic
risk or disease
if including
thrombogenic cardiac
diseases
Diseases of
esophagus, peptic
ulcer
With all K values<0.4
914
2,219
0.67
0.99
(0.38)
(0.27)
0.66
914
1,911
1,739
6,439
0.65
0.67
0.99
0.95
0.44
(0.37)
(0.18)
0.64
0.64
M, C, R
(0.29)
1,911
5,985
0.66
0.96
(0.30)
(0.20)
0.64
C, R
1,656
5,727
0.54
0.96
(0.23)
(0.14)
0.52
1,656
4,260
0.52
0.97
(0.28)
(0.19)
0.50
6,122
29,427
0.72
0.76
(0.18)
(0.10)
0.61
17,804
29,427
0.73
0.82
0.45
(0.33)
0.63
M, C, R
3,805
31,331
0.72
0.73
(0.11)
(0.05)
0.60
c
C, R
Acute diseases with time limited treatment, minor or rare conditions as inpatients
Migraine
Vertigo
Bacterial infection or
septicemia
Eye inflammation
Dermatitis
Mycosis
Other diseases of
upper respiratory tract
– allergy
Disorders of external
ear
Parasitosis
Other acute upper
respiratory infections
Acne
Psoriasis
Gout
Female inflammatory
diseases
Conjonctivitis
Hemorrhoids
Skin or subcutaneous
601
623
10,433
1,771
2,084
41,704
0.29
0.29
0.58
0.99
0.98
0.64
(0.14)
(0.13)
(0.13)
(0.09)
(0.08)
(0.05)
0.28
0.28
0.32
C
467
1,091
988
466
6,827
14,461
16,971
9,917
0.33
0.33
0.36
0.31
0.94
0.87
0.85
0.91
(0.04)
(0.03)
(0.03)
(0.02)
(0.02)
(0.02)
(0.01)
(0.01)
0.29
0.23
0.25
0.24
C
C,R
C
C
71
2,070
0.27
0.98
(0.02)
(0.01)
0.25
C
61
856
1,984
32,259
0.26
0.50
0.98
0.71
(0.01)
(0.01)
(0.01)
(0.01)
0.25
0.28
C
72
466
659
864
2,774
1,188
2,126
6,331
0.25
0.35
0.39
0.25
0.97
0.99
0.98
0.94
(0.01)
(0.19)
(0.18)
(0.05)
(0.01)
(0.13)
(0.12)
(0.03)
0.23
0.34
0.38
0.20
C,R
C,R
C,R
114
1,188
695
6,458
3,048
9,565
0.24
0.19
0.21
0.94
0.97
0.91
(0.01)
(0.10)
(0.02)
(0.00)
(0.06)
(0.01)
0.19
0.16
0.14
c
c
c
2
infections
Paludism
28 28
444
444 0.14
0.14
Intestinal infectious
1,608
7,131 0.19
diseases
Viral diseases
1,261
1,801 0.15
Influenza
177
74 0.00
Multiple diagnoses indication of tracer drugs
Inflammatory
1,321
6,526 0.39
polyarthritis and
connective tissue
disorders
Anaemias –
3,122
11,845 0.31
nutritional
Other mental and
7,852
28,126 0.54
behavioral disorders
Pain
12,341
66,022 0.73
d
Severe pain
12,341
7,429 0.16
Prophylaxis treatment
Tuberculosis
216
226 0.31
Active tuberculosis
216
82 0.25
Alternatives to pharmacological treatment
Neutropenia
468
369 0.18
Extended to
1,452
369 0.16
prophylaxis of
myelosuppressive
chemotherapy
Obesity
6,106
639 0.03
Other endocrine
8,393
160 0.00
nutritional and
metabolic diseases
Hemorrhagic risk or
1,434
756 0.05
disease
Poisonings
1,061
309 0.00
Heart failure
3,166
94 0.00
Alternative refinement: see hypertension/heart failure above
Abuse of tobacco
7,062
14 0.00
1.00
0.94
(0.02)
0.02
(0.06)
(0.01)
0.01
(0.03)
0.14
0.14
0.13
0.98
0.00
(0.11)
(0.00)
(0.09)
0.13
0.94
(0.12)
(0.07)
0.35
c
0.90
(0.10)
(0.06)
0.23
c
0.76
(0.16)
(0.08)
0.37
c
0.41
0.92
(0.07)
(0.13)
(0.02)
(0.13)
0.31
0.07
c
1.00
1.00
(0.30)
(0.36)
(0.29)
(0.66)
0.30
0.25
C, R
1.00
1.00
(0.21)
(0.25)
0.26
0.63
(0.17)
(0.16)
C, R
1.00
1.00
(0.05)
(0.01)
0.23
0.19
(0.02)
(0.00)
0.99
(0.07)
0.09
(0.05)
1.00
1.00
(0.00)
(0.00)
0.00
0.02
(0.00)
(0.00)
1.00
(0.00)
0.08
(0.00)
c
a
Kappa values, not used as judgment criteria are in parenthesis
Context of use: morbidity indicator (M), ambulatory costs control (C), insurers’ risk
adjustment (R) only for chronic conditions
c Appropriateness of pharmacologic treatment uncertain, prone to practice variations.
d
Strong opioids.
b
3