Volume 5, Number 6—December 1999
Supplementing Tuberculosis Surveillance with Automated Data from Health Maintenance Organizations
|Screening criteria||No. meeting screening criteria||No. TB cases detected using screening criteria||No. TB cases unknown to public health dept||Sensitivity (95% CI)||Positive predictive value (95% CI)|
|All patients (45 incident TB cases)|
|Two or more anti-TB drugsa||133||40||7||89 (76,96)||30 (22, 39)|
|Two or more anti-TB drugsa dispensed on the same date||108||39||7||87 (73,95)||36 (27,50)|
|Three or more anti-TB drugsa||76||38||7||84 (71,94)||50 (38,62)|
|Only patients with automated medical records (41 incident TB cases)|
|One or more anti-TB drugs,a a microbiology code,b and a radiology codec||132||21||2||51 (35, 67)||16 (10, 23)|
|At least one anti-TB druga and a CPTc code for mycobacterial culture/stain||106||17||2||42 (26,58)||16 (10,24)|
|Diagnosis coded for tuberculosis, a microbiology code,b and a radiology codec||49||16||0||39 (24,56)||33 (20,48)|
|Diagnosis coded for positive PPD,e a microbiology code,b and a radiology codec||157||8||1||20 (9,35)||5 (2,10)|
|At least one anti-TB druga and an ICD-9 diagnosis code for tuberculosis||14||7||1||17 (7,32)||50 (23,77)|
|ICD-9 procedure code for bronchoscopy, a microbiology code,b and a radiology codec||15||1||0||2 (0.1,13)||7 (0.2,32)|
|Diagnosis coded for active tuberculosis||4||1||0||2 (0.1,13)||25 (1,81)|
|Diagnosis coded for pulmonary tuberculosis||75||0||0||0||0|
|Diagnosis coded for tuberculin conversion, a microbiology code,b and a radiology codec||1||0||0||0||0|
|Only patients without automated medical records (4 incident TB cases)|
|ICD-9 diagnosis code for tuberculosis||251||4||2||100 (40, 100)||2 (0.4, 40)|
|A CPT code relating to mycobacterial culture/stain or a radiology code||92||2||1||50 (7, 93)||2 (0.3, 8)|
aPharmacy dispensing data; antituberculosis drugs include isoniazid, rifampin, pyrazinamide, ethambutol, streptomycin, capreomycin, kanamycin, ethionamide, para-aminosalicyclic acid, and cycloserine.
bMicrobiology codes include COSTAR (coding system for automated ambulatory-patient records ) or ICD-9CM (International Classification of Diseases, 9th Revision Clinical Modification) procedure codes for acid fast bacilli smear, culture and sensitivities and microscopy examination of sputum.
cRadiology codes include current procedures terminology (CPT), COSTAR, or ICD-9 procedure codes for chest radiograph, thoracic computer assisted tomography (CT), or thoracic magnetic resonance imaging (MRI).
dAmbulatory codes were obtained from automated ambulatory-patient records in the staff model division and from claims in the network and group model division.
ePPD, purified protein derivative.
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