{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:31:05Z","timestamp":1791487865234,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,10,3]],"date-time":"2010-10-03T00:00:00Z","timestamp":1286064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Suicidal behavior has gained attention as an adverse outcome of prescription drug use. Hospitalizations for intentional self\u2010harm, including suicide, can be identified in administrative claims databases using external cause of injury codes (E\u2010codes). However, rates of E\u2010code completeness in US government and commercial claims databases are low due to issues with hospital billing software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop an algorithm to identify intentional self\u2010harm hospitalizations using recorded injury and psychiatric diagnosis codes in the absence of E\u2010code reporting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We sampled hospitalizations with an injury diagnosis (ICD\u20109 800\u2013995) from two databases with high rates of E\u2010coding completeness: 1999\u20132001 British Columbia, Canada data and the 2004 US Nationwide Inpatient Sample. Our gold standard for intentional self\u2010harm was a diagnosis of E950\u2010E958. We constructed algorithms to identify these hospitalizations using information on type of injury and presence of specific psychiatric diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The algorithm that identified intentional self\u2010harm hospitalizations with high sensitivity and specificity was a diagnosis of poisoning, toxic effects, open wound to elbow, wrist, or forearm, or asphyxiation; plus a diagnosis of depression, mania, personality disorder, psychotic disorder, or adjustment reaction. This had a sensitivity of 63%, specificity of 99% and positive predictive value (PPV) of 86% in the Canadian database. Values in the US data were 74, 98, and 73%. PPV was highest (80%) in patients under 25 and lowest those over 65 (44%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proposed algorithm may be useful for researchers attempting to study intentional self\u2010harm in claims databases with incomplete E\u2010code reporting, especially among younger populations. Copyright \u00a9 2010 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.2037","type":"journal-article","created":{"date-parts":[[2010,10,4]],"date-time":"2010-10-04T04:04:33Z","timestamp":1286165073000},"page":"1263-1275","source":"Crossref","is-referenced-by-count":61,"title":["Identification of hospitalizations for intentional self\u2010harm when E\u2010codes are incompletely recorded"],"prefix":"10.1002","volume":"19","author":[{"given":"Amanda R.","family":"Patrick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine W.","family":"Barber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire F.","family":"Canning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schneeweiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,10,3]]},"reference":[{"key":"e_1_2_9_2_2","unstructured":"Food and Drug Administration. Summary minutes of the September 13\u201314 2004 Center for Drug Evaluation and Research Pharmachopharmacologic Drugs Advisory Committee and the FDA Pediatric Advisory Committee.http:\/\/www.fda.gov\/ohrms\/dockets\/ac\/04\/minutes\/2004\u20104065 M1_Final.htmAccessed February 1 2005."},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.3.332"},{"key":"e_1_2_9_4_2","unstructured":"Food and Drug Administration. Information for Healthcare Professionals Suicidality and Antiepileptic Drugs January 31 2008;http:\/\/www.fda.gov\/cder\/drug\/InfoSheets\/HCP\/antiepilepticsHCP.htmAccessed December 22 2008."},{"key":"e_1_2_9_5_2","unstructured":"Food and Drug Administration. Public Health Advisory. Important Information on Chantix (varenicline).http:\/\/www.fda.gov\/cder\/drug\/advisory\/varenicline.htmAccessed January 15 2009."},{"key":"e_1_2_9_6_2","unstructured":"Food and Drug Administration. FDA safety update: asthma medications.http:\/\/www.fda.gov\/consumer\/asthmameds051308.htmlAccessed January 15 2009."},{"key":"e_1_2_9_7_2","unstructured":"MundyA. Drugs' links to suicide risk draw concern. The Wall Street Journal (Eastern edition). July 9 2008."},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001270050241"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.410"},{"key":"e_1_2_9_10_2","unstructured":"Centers for Disease Control and Prevention National Center for Injury Prevention and Control. Web\u2010based Injury Statistics Query and Reporting System (WISQARS):www.cdc.gov\/ncipc\/wisqars"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2317"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.39"},{"key":"e_1_2_9_13_2","unstructured":"Council of State and Territorial Epidemiologists; Data Committee Injury Control and Emergency Health Services Section American Public Health Association; and State and Territorial Injury Prevention Directors Association. How states are collecting and using cause of injury data: 2004 update to the 1997 Report 2005."},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2004.52560.x"},{"key":"e_1_2_9_15_2","unstructured":"WilliamsJI YoungW. Inventory of studies on the accuracy of Canadian health administrative databases.Technical Report Institute for Clinical Evaluative Sciences (ICES) December 1996."},{"key":"e_1_2_9_16_2","unstructured":"HCUP Nationwide Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP). 2000\u20132001. Agency for healthcare research and quality Rockville MD.www.hcup\u2010us.ahrq.gov\/nisoverview.jsp"},{"key":"e_1_2_9_17_2","unstructured":"BarrettM SteinerC CobenJ U.S. Agency for Healthcare Research and Quality. Healthcare cost and utilization project (HCUP) E code evaluation report. 2004. HCUP methods series report # 2004\u201006 ONLINE. April 14 2005."},{"key":"e_1_2_9_18_2","unstructured":"Injury Surveillance Workgroup. Consensus recommendations for using hospital discharge data for injury surveillance. Marietta (GA): State and Territorial Injury Prevention Directors Association;2003."},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2006.08.001"},{"key":"e_1_2_9_20_2","volume-title":"Modern Epidemiology","author":"Rothman KJ","year":"2008"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.10.012"},{"key":"e_1_2_9_22_2","unstructured":"British Columbia Injury Research and Prevention Unit.BCIRPU Online Data Tool. 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