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Alternate benchmarking measures evaluated for UTI

Tieder JS. Pediatrics. 2011;128:323-330.

Looking at the ICD-9 codes may be another way to help test accuracy benchmarks for patients who have urinary tract infections, according to data published this week from five children’s hospitals across the United States.

Joel S. Tieder, MD, MPH, and colleagues from the University of Washington School of Medicine looked at data from a public health information system and medical records on 833 children aged 3 days to 18 years. All of the children had been admitted to one of the five children’s hospitals, undergone a urinalysis or urine culture, and subsequently discharged. The researchers assessed the positive predictive value of the IDC-9 codes, using “common UTI identification strategies.”

The researchers said the positive predictive value was about 50% “with the use of the gold standard of laboratory-confirmed UTIs but increased to 85% with provider confirmation. Restriction of the study cohort to patients with a [principal] diagnosis of UTI improved the [positive predictive value] for laboratory-confirmed UTI (61.2%) and provider-confirmed UTI (93.2%), as well as the ability to benchmark performance.”

The researchers said their data suggest that these codes could be used to measure “the accuracy and applicability of benchmarking.”

There were a few study limitations, according to the researchers, such as the results were based on administrative data from a central database. “It is not clear whether these results can be applied to other administrative data sets or to non-children’s hospitals,” they said, adding that each site’s reliability of “data abstractors” was not evaluated.

Disclosure: The researchers reported no relevant financial disclosures.

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