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Validity of clinical psoriatic arthritis diagnoses made by rheumatologists in the Swedish National Patient Register
Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology, Skåne University Hospital, Lund, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Center for Clinical Research (CKF) Dalarna, Uppsala University, Falun, Sweden; Department of Rheumatology, Falun Hospital, Falun, Sweden.
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2023 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 52, no 4, p. 374-384Article in journal (Refereed) Published
Abstract [en]

Objectives: Knowledge of the correspondence between clinical ICD diagnoses and classification criteria fulfilment is crucial to interpret studies identifying cases via ICD codes. We assessed the degree to which patients registered with ICD-10 diagnoses of psoriatic arthritis (PsA) in the Swedish National Patient Register (NPR) fulfil established PsA classification criteria. Method: Four hundred patients with at least one outpatient visit to one of five rheumatology or internal medicine departments (three university/two county departments across Sweden) in 2013–2015, with a main ICD-10 diagnosis of PsA (L40.5–M07.3), were randomly selected (80 cases/site). Through a structured medical record review, positive predictive values (PPVs) for fulfilment of the following classification criteria were assessed: CASPAR, Moll and Wright, Vasey and Espinoza, and modified ESSG criteria for PsA. A subset analysis regarding CASPAR fulfilment was also performed among cases with available rheumatoid factor and peripheral X-ray status (central CASPAR items; n = 227). Results: Of the 400 patients with a main ICD-10 diagnosis of PsA, 343 (86%) fulfilled at least one of the four PsA classification criteria. PPVs for the different criteria were: CASPAR 69% (82% in the subset analysis), Moll and Wright 51%, Vasey and Espinoza 76%, and modified ESSG 64%. Overall, only 6.5% of the 400 PsA diagnoses were judged as clearly incorrect by the medical record reviewers. Conclusion: The validity of rheumatologist-made, clinical ICD-10 diagnoses for PsA in the Swedish NPR is good, with PPVs of 69–82% for CASPAR fulfilment and 86% for meeting any established PsA classification criteria.

Place, publisher, year, edition, pages
Taylor & Francis, 2023. Vol. 52, no 4, p. 374-384
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-203055DOI: 10.1080/03009742.2022.2066807ISI: 000807017800001PubMedID: 35659437Scopus ID: 2-s2.0-85131561419OAI: oai:DiVA.org:umu-203055DiVA, id: diva2:1727788
Available from: 2023-01-17 Created: 2023-01-17 Last updated: 2025-02-18Bibliographically approved

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Alenius, Gerd-Marie

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CiteExportLink to record
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