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Table 2 Sensitivity, positive predictive value, and agreement of M05 and M06 diagnosis codes in RA patients compared to various lab-based gold standards

From: Use of ICD-10 diagnosis codes to identify seropositive and seronegative rheumatoid arthritis when lab results are not available

   RISE EHR MarketScan administrative claims
Lab test result (gold standard): definition of positive N, patients Sensitivity PPV Kappa N Sensitivity PPV Kappa
M05 Any positive RF: ≥ 14 or positive 31,827 0.82 (0.81, 0.82) 0.81 (0.80, 0.82) 0.61 (0.60, 0.62) 1115 0.73 (0.70, 0.76) 0.84 (0.81, 0.87) 0.45 (0.40, 0.50)
High positive RF: ≥ 42* 24,224 0.86 (0.86, 0.87) 0.73 (0.72, 0.73) 0.61 (0.60, 0.62) 840 0.74 (0.69, 0.78) 0.72 (0.68, 0.76) 0.44 (0.38, 0.50)
Any positive anti-CCP: ≥ 20 or positive 38,859 0.76 (0.75, 0.76) 0.68 (0.67, 0.69) 0.41 (0.40, 0.42) 261 0.64 (0.56, 0.71) 0.76 (0.68, 0.83) 0.24 (0.13, 0.36)
High-positive anti-CCP ≥ 60** 34,490 0.82 (0.81, 0.82) 0.63 (0.63, 0.64) 0.45 (0.44, 0.46) 201 0.66 (0.57, 0.75) 0.67 (0.57, 0.76) 0.29 (0.16, 0.42)
Any positive RF or anti-CCP (RF ≥ 14 or positive) or (anti-CCP ≥ 20 or positive) 43,581 0.76 (0.75, 0.76) 0.82 (0.82, 0.83) 0.51 (0.51, 0.52) 1185 0.73 (0.69, 0.77) 0.84 (0.81, 0.87) 0.45 (0.40, 0.50)
Any high-positive RF or anti-CCP: RF ≥ 42 or anti-CCP ≥ 60*** 40,452 0.83 (0.82, 0.83) 0.71 (0.70, 0.71) 0.53 (0.52, 0.54) 927 0.73 (0.69–0.77) 0.71 (0.67–0.75) 0.42 (0.36, 0.48)
M06 Not RF-positive 31,827 0.80 (0.79, 0.80) 0.80 (0.79, 0.81) 0.61 (0.60, 0.62) 1115 0.74 (0.7, 0.79) 0.59 (0.55, 0.64) 0.45 (0.40, 0.50)
Not RF high-positive* 24,224 0.76 (0.76, 0.77) 0.89 (0.88, 0.89) 0.61 (0.60, 0.62) 840 0.70 (0.65, 0.75) 0.72 (0.67, 0.76) 0.44 (0.38, 0.50)
Not positive for anti-CCP 38,859 0.66 (0.65, 0.66) 0.74 (0.73, 0.74) 0.41 (0.40, 0.42) 261 0.63 (0.52, 0.73) 0.48 (0.39, 0.57) 0.24 (0.13, 0.36)
Not high-positive for Anti-CCP** 34,490 0.65 (0.65, 0.66) 0.83 (0.82, 0.83) 0.45 (0.44, 0.46) 201 0.63 (0.52, 0.73) 0.62 (0.52, 0.72) 0.29 (0.16, 0.42)
Not positive for RF or Anti-CCP-positive 43,581 0.77 (0.76, 0.77) 0.69 (0.68, 0.69) 0.51 (0.51, 0.52) 1185 0.74 (0.70, 0.79) 0.60 (0.56, 0.64) 0.45 (0.40, 0.50)
Not high-positive for RF or anti-CCP*** 40,452 0.71 (0.70, 0.71) 0.83 (0.82, 0.83) 0.53 (0.52, 0.54) 927 0.69 (0.64, 0.73) 0.71 (0.67, 0.76) 0.42 (0.36, 0.48)
  1. RA rheumatoid arthritis, EHR electronic health record, PPV positive predictive value
  2. *Excluded those 14 < RF < 42
  3. **Excluded those 20 < anti-CCP < 60
  4. ***Excluded those 14 < <RF < 42 and 20 < anti-CCP < 60