Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Diabetes Care 30:e98 2007
DOI: 10.2337/dc07-0903
© 2007 by the American Diabetes Association
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ding, E. L.
Right arrow Articles by Liu, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ding, E. L.
Right arrow Articles by Liu, S.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Online Letters: Comments and Responses

Accuracy of Administrative Coding for Type 2 Diabetes in Children, Adolescents, and Young Adults

Response to Rhodes et al.

Eric L. Ding, SCD1,2,3, Yiqing Song, MD, SCD1, JoAnn E. Manson, MD, DRPH1,2, Aruna D. Pradhan, MD, MPH1, Julie E. Buring, SCD1,2,4 and Simin Liu, MD, SCD1,2,5,6

1 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
2 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
3 Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
4 Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts
5 Department of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles, California
6 Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California

Address correspondence to Simin Liu, MD, ScD, MPH, Program on Genomics and Nutrition, Department of Epidemiology, UCLA School of Public Health, Medicine, UCLA David Geffen School of Medicine, CHS 73-265 Box 951772, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772. E-mail: siminliu{at}ucla.edu

In a recent study, Rhodes et al. (1) questioned the accuracy of administrative coding for type 2 diabetes in children and young adults, noting a very low positive predictive value (PPV) of 16.6%. The article also highlighted the importance of adopting standardized and validated diagnostic protocols in epidemiologic studies.

Using diagnostic criteria from the American Diabetes Association (ADA) (2), we assessed the validity of self-reported diabetes diagnosis in a cohort of 39,876 women aged ≥45 years who were without heart disease, stroke, or cancer at baseline, as previously described (3). In annual, longitudinal, follow-up waves, all participants were requested to report repeated and updated diabetes status via a standardized protocol that was applied in a blinded manner to the full cohort. Several approaches were used to validate self-reports, including physician-led telephone interviews of 473 women (446 responders) who self-reported diabetes (4), supplemental questionnaires requesting detailed diagnostic information mailed to a separate random sample of 147 women who self-reported diabetes (136 responders), and medical records that were obtained (86% available) from consenting women (n = 113) in the former two groups.

In our validation study, self-reported diabetes was confirmed in 406 women via physician-led telephone interviews (91% PPV [95% CI 88–94%]), whereas 124 cases were confirmed (91% [86–96]) using the supplemental questionnaire. In addition, 89 of the 90 women who provided medical records had confirmed diabetes using criteria of the ADA (positive self-report plus supplemental questionnaire vs. medical records, 99% PPV [95% CI 97–100]). The results also found that the ADA criteria identified 12% more cases than the National Diabetes Data Group criteria and 6% more cases than the World Health Organization criteria.

Our findings indicate that the PPV of self-reported diabetes was very high in this cohort of adult women, which is in contrast to the 16.6% PPV for administratively coded type 2 diabetes among children and young adults (1). The PPVs in our study also did not differ by methods used (PPV 91% for both methods, P = 0.96), thereby attesting to the validity and robustness of self-reported diagnostic information. Even in sensitivity analysis conservatively categorizing all nonresponders as nondiabetic individuals, PPVs remained robust and high at 86 and 84% via the two primary validation approaches (physician-led telephone interviews and the supplemental questionnaire, respectively).

In contrast with administrative coding of type 2 diabetes reported by Rhodes et al., a standardized approach to annual assessment of self-reported type 2 diabetes yields excellent predictive ability and validity in a well-characterized cohort.

Acknowledgments

This study was supported by Grants DK66401, DK62290, and CA47988 from the National Institutes of Health.

References

  1. Rhodes ET, Laffel LMB, Gonzalez TV, Ludwig DS: Accuracy of administrative coding for type 2 diabetes in children, adolescents, and young adults. Diabetes Care 30:141–143, 2007[Free Full Text]
  2. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 20:1183–1197, 1997[Medline]
  3. Liu S, Lee IM, Song Y, Van Denburgh M, Cook NR, Manson JE, Buring JE: Vitamin E and risk of type 2 diabetes in the Women's Health Study randomized controlled trial. Diabetes 55:2856–2862, 2006[Abstract/Free Full Text]
  4. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM: C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 286:327–334, 2001[Abstract/Free Full Text]

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Arch Intern MedHome page
A. R. Weinstein, H. D. Sesso, I-M. Lee, K. M. Rexrode, N. R. Cook, J. E. Manson, J. E. Buring, and J. M. Gaziano
The Joint Effects of Physical Activity and Body Mass Index on Coronary Heart Disease Risk in Women
Arch Intern Med, April 28, 2008; 168(8): 884 - 890.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
E. T. Rhodes, L. M.B. Laffel, T. V. Gonzalez, and D. S. Ludwig
Accuracy of Administrative Coding for Type 2 Diabetes in Children, Adolescents, and Young Adults: Response to Ding et al.
Diabetes Care, September 1, 2007; 30(9): e99 - e99.
[Full Text] [PDF]

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ding, E. L.
Right arrow Articles by Liu, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ding, E. L.
Right arrow Articles by Liu, S.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum