Validation of a PHIS Esophageal Atresia and Tracheoesophageal Fistula Cohort in ICD‐10

Abstract

AbstractObjectiveValidation of a contemporary International Classification of Diseases, 10th Revision, Clinical Modification (ICD‐10‐CM) congenital esophageal atresia/tracheoesophageal atresia (EA/TEF) cohort in the Pediatric Health Information System (PHIS) database.Study DesignDatabase study, validation.SettingTertiary care center.MethodsSearch methods used to validate an ICD‐9‐CM EA/TEF cohort in PHIS were modified for ICD‐10‐CM. A retrospectively and prospectively maintained clinical database at a single high‐volume EA/TEF center was used for comparison. Patients treated between October 1, 2015 and July 31, 2022 were included. Searches progressively narrowed the cohort by ICD‐10‐CM diagnosis codes, expansion to include incorrectly coded as ‘iatrogenic, age less than 30 days, and use of at least 1 ICD‐10‐CM procedure code. Results of PHIS data and institution data were compared for accuracy.ResultsThe most refined search of PHIS and the EA/TEF clinical database yielded 93 and 84 patients, respectively. The sensitivity was 99% and positive predictive value was 94%. A PHIS search using these methods and encompassing 49 children's hospitals yielded an EA/TEF cohort of 2479 patients.ConclusionWe present a validated search method in the PHIS database to identify a high‐fidelity cohort of EA/TEF patients for multi‐institutional study. We have demonstrated that a carefully maintained clinical database may be used to validate cohorts in PHIS. This cohort allows for improved practice variability and outcomes study of EA/TEF patients. Similar methods may be employed to generate other rare disease cohorts in PHIS.Level of EvidenceLevel 4.