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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
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Arthritis Research & Therapy

ISSN: 1478-6362

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