Healthc Inform Res.  2022 Jul;28(3):240-246. 10.4258/hir.2022.28.3.240.

Effectiveness of the Use of Standardized Vocabularies on Epilepsy Patient Cohort Generation

Affiliations
  • 1Healthcare ICT Research Center, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 3Kakao Healthcare Company-In-Company, Seongnam, Korea

Abstract


Objectives
This study investigated the effectiveness of using standardized vocabularies to generate epilepsy patient cohorts with local medical codes, SNOMED Clinical Terms (SNOMED CT), and International Classification of Diseases tenth revision (ICD-10)/Korean Classification of Diseases-7 (KCD-7).
Methods
We compared the granularity between SNOMED CT and ICD-10 for epilepsy by counting the number of SNOMED CT concepts mapped to one ICD-10 code. Next, we created epilepsy patient cohorts by selecting all patients who had at least one code included in the concept sets defined using each vocabulary. We set patient cohorts generated by local codes as the reference to evaluate the patient cohorts generated using SNOMED CT and ICD-10/KCD-7. We compared the number of patients, the prevalence of epilepsy, and the age distribution between patient cohorts by year.
Results
In terms of the cohort size, the match rate with the reference cohort was approximately 99.2% for SNOMED CT and 94.0% for ICD-10/KDC7. From 2010 to 2019, the mean prevalence of epilepsy defined using the local codes, SNOMED CT, and ICD-10/KCD-7 was 0.889%, 0.891% and 0.923%, respectively. The age distribution of epilepsy patients showed no significant difference between the cohorts defined using local codes or SNOMED CT, but the ICD-9/KCD-7-generated cohort showed a substantial gap in the age distribution of patients with epilepsy compared to the cohort generated using the local codes.
Conclusions
The number and age distribution of patients were substantially different from the reference when we used ICD-10/KCD-7 codes, but not when we used SNOMED CT concepts. Therefore, SNOMED CT is more suitable for representing clinical ideas and conducting clinical studies than ICD-10/KCD-7.

Keyword

Systematized Nomenclature of Medicine; Terminology; Cohort Studies; Epilepsy; International Classification of Diseases

Figure

  • Figure 1 Design of the study. SNOMED CT: SNOMED Clinical Terms, ICD-10: International Classification of Diseases tenth revision, KCD-7: Korean Classification of Diseases-7.

  • Figure 2 Local, SNOMED CT, and ICD-10/KCD-7 codes for epilepsy. SNOMED CT: SNOMED Clinical Terms, ICD-10: International Classification of Diseases tenth revision, KCD-7: Korean Classification of Diseases-7.

  • Figure 3 Prevalence of epilepsy by year in the three cohorts. SNOMED CT: SNOMED Clinical Terms, ICD-10: International Classification of Diseases tenth revision, KCD-7: Korean Classification of Diseases-7.

  • Figure 4 Age distribution of the epilepsy patient cohorts by year (reference standard).

  • Figure 5 Difference in the age distribution of epilepsy patients by vocabularies in 2003. SNOMED CT: SNOMED Clinical Terms, ICD-10: International Classification of Diseases tenth revision, KCD-7: Korean Classification of Diseases-7.


Reference

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