%0 Journal Article
%T Validity of Physician Billing Claims to Identify Deceased Organ Donors in Large Healthcare Databases
%A Alvin Ho-ting Li
%A S. Joseph Kim
%A Jagadish Rangrej
%A Damon C. Scales
%A Salimah Shariff
%A Donald A. Redelmeier
%A Greg Knoll
%A Ann Young
%A Amit X. Garg
%J PLOS ONE
%D 2013
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0070825
%X Objective We evaluated the validity of physician billing claims to identify deceased organ donors in large provincial healthcare databases. Methods We conducted a population-based retrospective validation study of all deceased donors in Ontario, Canada from 2006 to 2011 (n = 988). We included all registered deaths during the same period (n = 458,074). Our main outcome measures included sensitivity, specificity, positive predictive value, and negative predictive value of various algorithms consisting of physician billing claims to identify deceased organ donors and organ-specific donors compared to a reference standard of medical chart abstraction. Results The best performing algorithm consisted of any one of 10 different physician billing claims. This algorithm had a sensitivity of 75.4% (95% CI: 72.6% to 78.0%) and a positive predictive value of 77.4% (95% CI: 74.7% to 80.0%) for the identification of deceased organ donors. As expected, specificity and negative predictive value were near 100%. The number of organ donors identified by the algorithm each year was similar to the expected value, and this included the pre-validation period (1991 to 2005). Algorithms to identify organ¨Cspecific donors performed poorly (e.g. sensitivity ranged from 0% for small intestine to 67% for heart; positive predictive values ranged from 0% for small intestine to 37% for heart). Interpretation Primary data abstraction to identify deceased organ donors should be used whenever possible, particularly for the detection of organ-specific donations. The limitations of physician billing claims should be considered whenever they are used.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0070825