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
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/240487

id CONICETDig_f754f5c55b1e2c4298873d8cf282793f
oai_identifier_str oai:ri.conicet.gov.ar:11336/240487
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling 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
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1844614136263081984
score 13.070432