Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden
- Autores
- Giunta, Diego Hernan; Karlsson, Pär; Younus, Muhammad; Berglind, Ina Anveden; Kieler, Helle; Reutfors, Johan
- Año de publicación
- 2024
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Background Liver disorders are important adverse efects associated with antifungal drug treatment. However, the accuracy of Clinical International Classifcation of Diseases (ICD)-10 codes in identifying liver disorders for register based research is not well-established. This study aimed to determine the positive predictive value (PPV) of the ICD10 codes for identifying patients with toxic liver disease, hepatic failure, and jaundice among patients with systemic antifungal treatment. Methods Data from the Swedish Prescribed Drug Register and the National Patient Register were utilized to identify adult patients who received systemic azole antifungal drugs and had a recorded diagnosis of toxic liver disease (K71.0, K71.1, K71.2, K71.6, K71.8, K71.9), hepatic failure (K72.0, K72.9), or jaundice (R17) between 2005 and 2016. The medical records of all included patients were reviewed. Prespecifed criteria were used to re-evaluate and confrm each diagnosis, serving as the gold standard to calculate PPVs with 95% confdence intervals (95% CI) for each diagnostic group. Results Among the 115 included patients, 26 were diagnosed with toxic liver disease, 58 with hepatic failure, and 31 with jaundice. Toxic liver disease was confrmed in 14 out of 26 patients, yielding a PPV of 53.8% (95% CI 33.4–73.4%). Hepatic failure was confrmed in 26 out of 38 patients, resulting in a PPV of 62.1% (95% CI 48.4–74.5%). The highest PPV was found in jaundice, with 30 confrmed diagnoses out of 31, yielding a PPV of 96.8% (95% CI 83.3–99.9%). Conclusion Among patients who received azole antifungal treatment and were subsequently diagnosed with a liver disorder, the PPV for the diagnosis of jaundice was high, while the PPVs for toxic liver disease and hepatic failure were lower.
Fil: Giunta, Diego Hernan. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Karlsson, Pär. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
Fil: Younus, Muhammad. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
Fil: Berglind, Ina Anveden. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
Fil: Kieler, Helle. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
Fil: Reutfors, Johan. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia - Materia
-
Validation
Positive predictive value
Drug induced liver injury
Acute liver injury
Liver disorders
Toxic liver disease
Hepatic failure
Jaundice - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/240487
Ver los metadatos del registro completo
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CONICET Digital (CONICET) |
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Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in SwedenGiunta, Diego HernanKarlsson, PärYounus, MuhammadBerglind, Ina AnvedenKieler, HelleReutfors, JohanValidationPositive predictive valueDrug induced liver injuryAcute liver injuryLiver disordersToxic liver diseaseHepatic failureJaundicehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background Liver disorders are important adverse efects associated with antifungal drug treatment. However, the accuracy of Clinical International Classifcation of Diseases (ICD)-10 codes in identifying liver disorders for register based research is not well-established. This study aimed to determine the positive predictive value (PPV) of the ICD10 codes for identifying patients with toxic liver disease, hepatic failure, and jaundice among patients with systemic antifungal treatment. Methods Data from the Swedish Prescribed Drug Register and the National Patient Register were utilized to identify adult patients who received systemic azole antifungal drugs and had a recorded diagnosis of toxic liver disease (K71.0, K71.1, K71.2, K71.6, K71.8, K71.9), hepatic failure (K72.0, K72.9), or jaundice (R17) between 2005 and 2016. The medical records of all included patients were reviewed. Prespecifed criteria were used to re-evaluate and confrm each diagnosis, serving as the gold standard to calculate PPVs with 95% confdence intervals (95% CI) for each diagnostic group. Results Among the 115 included patients, 26 were diagnosed with toxic liver disease, 58 with hepatic failure, and 31 with jaundice. Toxic liver disease was confrmed in 14 out of 26 patients, yielding a PPV of 53.8% (95% CI 33.4–73.4%). Hepatic failure was confrmed in 26 out of 38 patients, resulting in a PPV of 62.1% (95% CI 48.4–74.5%). The highest PPV was found in jaundice, with 30 confrmed diagnoses out of 31, yielding a PPV of 96.8% (95% CI 83.3–99.9%). Conclusion Among patients who received azole antifungal treatment and were subsequently diagnosed with a liver disorder, the PPV for the diagnosis of jaundice was high, while the PPVs for toxic liver disease and hepatic failure were lower.Fil: Giunta, Diego Hernan. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Karlsson, Pär. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Younus, Muhammad. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Berglind, Ina Anveden. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Kieler, Helle. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Reutfors, Johan. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaBioMed Central2024-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/240487Giunta, Diego Hernan; Karlsson, Pär; Younus, Muhammad; Berglind, Ina Anveden; Kieler, Helle; et al.; Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden; BioMed Central; Bmc Gastroenterology; 24; 1; 1-2024; 1-81471-230XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-03110-winfo:eu-repo/semantics/altIdentifier/doi/10.1186/s12876-023-03110-winfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:17:55Zoai:ri.conicet.gov.ar:11336/240487instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:17:55.496CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
title |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
spellingShingle |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden Giunta, Diego Hernan Validation Positive predictive value Drug induced liver injury Acute liver injury Liver disorders Toxic liver disease Hepatic failure Jaundice |
title_short |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
title_full |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
title_fullStr |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
title_full_unstemmed |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
title_sort |
Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden |
dc.creator.none.fl_str_mv |
Giunta, Diego Hernan Karlsson, Pär Younus, Muhammad Berglind, Ina Anveden Kieler, Helle Reutfors, Johan |
author |
Giunta, Diego Hernan |
author_facet |
Giunta, Diego Hernan Karlsson, Pär Younus, Muhammad Berglind, Ina Anveden Kieler, Helle Reutfors, Johan |
author_role |
author |
author2 |
Karlsson, Pär Younus, Muhammad Berglind, Ina Anveden Kieler, Helle Reutfors, Johan |
author2_role |
author author author author author |
dc.subject.none.fl_str_mv |
Validation Positive predictive value Drug induced liver injury Acute liver injury Liver disorders Toxic liver disease Hepatic failure Jaundice |
topic |
Validation Positive predictive value Drug induced liver injury Acute liver injury Liver disorders Toxic liver disease Hepatic failure Jaundice |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.2 https://purl.org/becyt/ford/3 |
dc.description.none.fl_txt_mv |
Background Liver disorders are important adverse efects associated with antifungal drug treatment. However, the accuracy of Clinical International Classifcation of Diseases (ICD)-10 codes in identifying liver disorders for register based research is not well-established. This study aimed to determine the positive predictive value (PPV) of the ICD10 codes for identifying patients with toxic liver disease, hepatic failure, and jaundice among patients with systemic antifungal treatment. Methods Data from the Swedish Prescribed Drug Register and the National Patient Register were utilized to identify adult patients who received systemic azole antifungal drugs and had a recorded diagnosis of toxic liver disease (K71.0, K71.1, K71.2, K71.6, K71.8, K71.9), hepatic failure (K72.0, K72.9), or jaundice (R17) between 2005 and 2016. The medical records of all included patients were reviewed. Prespecifed criteria were used to re-evaluate and confrm each diagnosis, serving as the gold standard to calculate PPVs with 95% confdence intervals (95% CI) for each diagnostic group. Results Among the 115 included patients, 26 were diagnosed with toxic liver disease, 58 with hepatic failure, and 31 with jaundice. Toxic liver disease was confrmed in 14 out of 26 patients, yielding a PPV of 53.8% (95% CI 33.4–73.4%). Hepatic failure was confrmed in 26 out of 38 patients, resulting in a PPV of 62.1% (95% CI 48.4–74.5%). The highest PPV was found in jaundice, with 30 confrmed diagnoses out of 31, yielding a PPV of 96.8% (95% CI 83.3–99.9%). Conclusion Among patients who received azole antifungal treatment and were subsequently diagnosed with a liver disorder, the PPV for the diagnosis of jaundice was high, while the PPVs for toxic liver disease and hepatic failure were lower. Fil: Giunta, Diego Hernan. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Karlsson, Pär. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia Fil: Younus, Muhammad. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia Fil: Berglind, Ina Anveden. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia Fil: Kieler, Helle. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia Fil: Reutfors, Johan. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia |
description |
Background Liver disorders are important adverse efects associated with antifungal drug treatment. However, the accuracy of Clinical International Classifcation of Diseases (ICD)-10 codes in identifying liver disorders for register based research is not well-established. This study aimed to determine the positive predictive value (PPV) of the ICD10 codes for identifying patients with toxic liver disease, hepatic failure, and jaundice among patients with systemic antifungal treatment. Methods Data from the Swedish Prescribed Drug Register and the National Patient Register were utilized to identify adult patients who received systemic azole antifungal drugs and had a recorded diagnosis of toxic liver disease (K71.0, K71.1, K71.2, K71.6, K71.8, K71.9), hepatic failure (K72.0, K72.9), or jaundice (R17) between 2005 and 2016. The medical records of all included patients were reviewed. Prespecifed criteria were used to re-evaluate and confrm each diagnosis, serving as the gold standard to calculate PPVs with 95% confdence intervals (95% CI) for each diagnostic group. Results Among the 115 included patients, 26 were diagnosed with toxic liver disease, 58 with hepatic failure, and 31 with jaundice. Toxic liver disease was confrmed in 14 out of 26 patients, yielding a PPV of 53.8% (95% CI 33.4–73.4%). Hepatic failure was confrmed in 26 out of 38 patients, resulting in a PPV of 62.1% (95% CI 48.4–74.5%). The highest PPV was found in jaundice, with 30 confrmed diagnoses out of 31, yielding a PPV of 96.8% (95% CI 83.3–99.9%). Conclusion Among patients who received azole antifungal treatment and were subsequently diagnosed with a liver disorder, the PPV for the diagnosis of jaundice was high, while the PPVs for toxic liver disease and hepatic failure were lower. |
publishDate |
2024 |
dc.date.none.fl_str_mv |
2024-01 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/240487 Giunta, Diego Hernan; Karlsson, Pär; Younus, Muhammad; Berglind, Ina Anveden; Kieler, Helle; et al.; Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden; BioMed Central; Bmc Gastroenterology; 24; 1; 1-2024; 1-8 1471-230X CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/240487 |
identifier_str_mv |
Giunta, Diego Hernan; Karlsson, Pär; Younus, Muhammad; Berglind, Ina Anveden; Kieler, Helle; et al.; Validation of diagnoses of liver disorders in users of systemic azole antifungal medication in Sweden; BioMed Central; Bmc Gastroenterology; 24; 1; 1-2024; 1-8 1471-230X CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-03110-w info:eu-repo/semantics/altIdentifier/doi/10.1186/s12876-023-03110-w |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
BioMed Central |
publisher.none.fl_str_mv |
BioMed Central |
dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) |
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CONICET Digital (CONICET) |
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Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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13.070432 |