Table 1.
Validation algorithms of study health-related adverse outcomes
| Outcome parameter (ICD-9 codes)a |
Validation algorithm | |
|---|---|---|
| Cardiovascular disease (410–414, 426–428, 430–438) |
Ischemic heart disease (410–414) |
• Evidence of angina pectoris symptoms or acute coronary syndrome, and/or • Imaging report (Angiography) |
| Congestive heart failure (428) |
• EF < 40 %, and/or • ≥3 dispensed prescriptions of diuretics, ACEI/ARB, or digoxin within six months following heart failure diagnosis [36] |
|
| Conduction disorders and cardiac dysrhythmias (426–427) |
• Direct-current cardioversion-defibrillation, pacemakers implantable cardioverter-defibrillators, radiofrequency ablation, and/or • ≥3 dispensed prescriptions of antiarrhythmic agents within 6 months following event |
|
| Stroke (430–438) |
• Hospitalization discharge sheet indicating a cerebral event, and/or • Imaging report (CT, PET, MRI), and/or • ≥3 dispensed prescriptions of anticoagulant agents within 6 months following event |
|
| Fractures (800–829) |
• Imaging report (radiographs), and/or • Orthopedic referrals • Operations on the musculoskeletal system (ICD-9 codes 76–84) • Orthopedic aftercare (ICD-9 code V54) |
|
| Osteoporosis (733.0) |
• Bone mineral density (T-score ≤ −2.5) [37], and/or • ≥1 dispensed prescriptions of bisphosphonates or estrogen agonist/antagonist (raloxifene) within 1 year following event |
|
| Diabetes (250) |
• HbA1c level ≥6.5 %, or FPG ≥ 126 mg/dL, or 2-hour PG ≥200 mg/Dl [38], and/or • ≥3 dispensed prescriptions of insulin and oral diabetes medications within 6 months following diabetes diagnosis |
|
| Chronic painb | • Concordance with the Hebrew validated Short Form 36 (SF-36) [17] | |
Abbreviations: ICD-9 International Classification of diseases, Ninth Revision, EF ejection fraction, ACEI angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, CT computerized tomography, PET positron emission tomography, MRI magnetic resonance imaging, HbA1c hemoglobin A1C, FPG fasting plasma glucose, 2-PG 2-hour post glucose‑load plasma glucose
a To account for possible variance in physician interpretation of ICD-9 codes and to increase the sensitivity of this tool, the current study referred only to the first three digits of ICD code for disease diagnosis [39], except for osteoporosis, which is a specific disorder of bone and cartilage
b Chronic pain defined as pain persisting 3 months, beyond the normal time of healing [40]