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Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center
Hua M, Li G, Clancy C, Morrison RS, Wunsch H.. Journal of palliative medicine, 2016-12-07
Topic: Risk, prevention and care in population studies
Background Use of administrative data to study the effectiveness of specialized palliative care is limited by the lack of a reliable method to identify patients receiving palliative care consultation. The International Classification of Diseases, Ninth Revision (ICD-9) code V66.7 has been used, but its validity for this purpose is unknown. Objective To examine the validity of the ICD-9 code V66.7 for identifying whether hospitalized patients received palliative care consultation. Design Retrospective cohort study. Setting/subjects All patients of age ≥18 years admitted to a single academic medical center between August 2013 and August 2015. Measurements Sensitivity and specificity of the V66.7 code for palliative care consultation for all patients and several a priori identified subgroups. The reference standard was the presence of a palliative care consultation note in the electronic medical record. Results Of 100,910 admissions, 1999 received a palliative care consultation (2.0%) and 1846 (1.8%) had usage of the V66.7 code. Sensitivity and specificity for the V66.7 code were 49.9% and 99.1%, respectively. Sensitivity was considerably higher for certain subgroups, such as patients with dementia (76.3%) and metastatic cancer (66.3%); addition of age restrictions further improved sensitivity while maintaining high specificity. Specificity was substantially lower for patients who died during hospitalization (sensitivity 53.9%, specificity 75.1%). Conclusions In a single center, the ICD-9 code V66.7 had poor sensitivity and high specificity for identifying hospitalized patients who received a palliative care consultation. Appropriate use of this code for this purpose should take these characteristics into consideration.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Hua, M., Li, G., Clancy, C., Morrison, R. S., & Wunsch, H. (2017). Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center. Journal of palliative medicine. https://doi.org/10.1089/jpm.2016.0363
Vancouver
Hua M, Li G, Clancy C, Morrison RS, Wunsch H. Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center. Journal of palliative medicine. 2017. doi:10.1089/jpm.2016.0363. PMID: 27925839.
BibTeX
@article{hua2017-27925839,
author = {Hua, M. and Li, G. and Clancy, C. and Morrison, R. S. and Wunsch, H.},
title = {{Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center}},
journal = {Journal of palliative medicine},
year = {2017},
doi = {10.1089/jpm.2016.0363},
pmid = {27925839},
url = {https://doi.org/10.1089/jpm.2016.0363}
}
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Key findings
- Results Of 100,910 admissions, 1999 received a palliative care consultation (2.0%) and 1846 (1.8%) had usage of the V66.7 code.
Study details
- Study designcohort study
- Effect size2.0%; 1.8%; 49.9%
- Evidence strengthModerate
How this study scored 57/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 33 of the 58 points we could judge it on, which is 57 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of palliative medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27925839) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 33 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 33 of the 58 points we could judge it on is 57 out of 100. |
| Total | 57 / 100 | — |
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