{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:49:26Z","timestamp":1790041766284,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Systematic identification of patients with cirrhosis through electronic healthcare records (EHRs) using ICD\u201010 codes is essential for epidemiological research but is prone to discrepancies. We aim to validate and improve a recent consensus code set of nine ICD\u201010 codes to identify cirrhosis in a multi\u2010ethnic Asian population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We applied an initial broad algorithm of 25 ICD\u201010 codes related to cirrhosis and its complications to identify patients potentially with cirrhosis admitted to Singapore General Hospital in 2018 and confirmed true cirrhosis cases via manual EHR review. We evaluated the consensus code set's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in identifying cirrhosis cases. We examined alternative code sets to improve cirrhosis identification and validated them in another local hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One thousand, seven hundred thirty\u2010three patients potentially with cirrhosis were identified, with 937 (54.1%) confirmed. The median age at diagnosis was 71\u2009years (IQR: 64\u201378), with 65.6% males, 75.2%\/8.8%\/9.3%\/6.7% Chinese\/Indians\/Malays\/Others, and 56.7% Child\u2010Pugh A. The main etiologies were chronic hepatitis B (29.5%) and metabolic dysfunction\u2013associated steatotic liver disease (25.5%). The consensus code set demonstrated sensitivity\/specificity\/PPV\/NPV of 76.1%\/82.0%\/83.3%\/74.5%, respectively. We identified a set of 10 ICD\u201010 codes (SingHealth Chronic Liver Disease Registry [SoLiDaRity]\u201010) with sensitivity\/specificity\/PPV\/NPV of 76.5%\/84.8%\/85.6%\/75.4%, respectively, demonstrating an improved specificity versus the consensus code set (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). External validation in another local hospital with 578 patients potentially with cirrhosis demonstrated improved sensitivity of the SoLiDaRity\u201010 code set versus the consensus code set (<jats:italic>p<\/jats:italic>\u2009=\u20090.033) (sensitivity\/specificity\/PPV\/NPV: 78.0%\/93.6%\/94.1%\/76.4% vs. 76.2%\/93.6%\/94.0%\/75.0%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While the consensus code set performs well in identifying patients with cirrhosis in a multi\u2010ethnic Asian population, we propose the improved SoLiDaRity\u201010 code set.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.70156","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T09:59:02Z","timestamp":1746525542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Validation of ICD\u201010 Consensus Code Set for Cirrhosis Detection Using Electronic Health Records in an Asian Population"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2702-8412","authenticated-orcid":false,"given":"Jason Pik\u2010Eu","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Singapore General Hospital  Singapore Singapore"},{"name":"Duke\u2010NUS Medical School  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1307-2069","authenticated-orcid":false,"given":"Hong\u2010Yi","family":"Lin","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooi\u2010Ling","family":"Loi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette Pei\u2010Xuan","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"De Roza","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School  Singapore Singapore"},{"name":"Department of Gastroenterology and Hepatology Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-4821","authenticated-orcid":false,"given":"Rahul","family":"Kumar","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School  Singapore Singapore"},{"name":"Department of Gastroenterology and Hepatology Changi General Hospital  Singapore 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