Diagnostic accuracy of algorithms to define incident and second hip fractures: A Taiwan validation study

Shau Huai Fu, Ping Ying Yu, Chung Yi Li, Chih Chien Hung, Chia Che Lee, Hsuan Yu Chen, Ta Wei Tai, Jawl Shan Hwang, Rong Sen Yang, Hongsen Chiang, Sung Yen Lin, Chih Hsing Wu, Ling Chiao Liao, Chin Ju Chuang, Chiu Yi Wu, Cheng Ying Chang, Ming Tsung Lee, Chung Hwan Chen, Chen Yu Wang

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Previous epidemiological researchers have used various algorithms to identify a second hip fracture; however, there has been no validation of these algorithms to date. This study aimed to verify existing algorithms for identifying second hip fracture under the International Classification of Diseases diagnostic coding systems. Furthermore, we examined the validity of two newly proposed algorithms that integrated the concept of periprosthetic fractures and laterality of the ICD-10 coding system. Methods: Claims data of patients hospitalized for hip fracture from National Taiwan University Hospitals between 2007 and 2020 were retrieved. Hip fracture was confirmed by 2 orthopaedic surgeons with medical records and imaging data as gold standards. The validity of 9 existing and 2 newly proposed algorithms for identifying second hip fracture was evaluated. Results: The positive predictive value (PPV) range between 84% and 90% in existing algorithms for identifying second hip fractures. Noteworthy, the longer time interval for discrimination resulted in slightly increased PPV (from 87% to 90%), while decreased sensitivity noticeably (from 87% to 72%). When considering the information about periprosthetic fracture, the PPV increased to 91% without diminished sensitivity. The PPV of the newly proposed ICD-10-specific algorithm was 100%. Conclusion: Algorithms integrated clinical insights of periprosthetic fractures and laterality concept of ICD-10 coding system provided satisfactory validity and help precisely define second hip fracture in future database research.

Original languageEnglish
Pages (from-to)S82-S91
JournalJournal of the Formosan Medical Association
Volume122
DOIs
Publication statusPublished - 2023 Jan

All Science Journal Classification (ASJC) codes

  • General Medicine

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