{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T08:41:13Z","timestamp":1779266473700,"version":"3.51.4"},"reference-count":0,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical and Investigative Medicine"],"published-print":{"date-parts":[[2021,12,31]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Hospitalizations related to a neuropathic and\/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)\u2014each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario. <\/jats:p><\/jats:sec>","DOI":"10.25011\/cim.v44i4.37592","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T18:31:33Z","timestamp":1640975493000},"page":"E11-E16","source":"Crossref","is-referenced-by-count":7,"title":["ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer"],"prefix":"10.3138","volume":"44","author":[{"given":"Muzammil H.","family":"Syed","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Division of Vascular Surgery, Department of Surgery, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Al-Omran","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Division of Vascular Surgery, Department of Surgery, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Diabetes Action Canada, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Jacob-Brassard","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Division of Vascular Surgery, Department of Surgery, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel G.","family":"Ray","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Divisions of General Internal Medicine and Endocrinology and Metabolism, Department of Medicine, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad A.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Division of Vascular and Endovascular Surgery and the Centre for Surgery and Public Health, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Mamdani","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Data Science and Advanced Analytics, Unity Health Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"de Mestral","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Division of Vascular Surgery, Department of Surgery, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Diabetes Action Canada, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1696","container-title":["Clinical and Investigative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/cimonline.ca\/index.php\/cim\/article\/download\/37592\/28872","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/utppublishing.com\/doi\/pdf\/10.25011\/cim.v44i4.37592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T18:36:58Z","timestamp":1741891018000},"score":1,"resource":{"primary":{"URL":"https:\/\/utppublishing.com\/doi\/10.25011\/cim.v44i4.37592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,31]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,12,31]]}},"alternative-id":["10.25011\/cim.v44i4.37592"],"URL":"https:\/\/doi.org\/10.25011\/cim.v44i4.37592","relation":{},"ISSN":["1488-2353"],"issn-type":[{"value":"1488-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,31]]}}}