{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:35:33Z","timestamp":1791401733839,"version":"4.3.3"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Administrative and clinical databases are increasingly used for research, but their value depends on coding accuracy. The Spanish National Hospital Discharge Database (CMBD) is a standardised registry widely applied in epidemiology. Type 1 diabetes mellitus (T1DM) is an autoimmune disease with early onset and long-term complications. This study aimed to validate the accuracy of T1DM diagnoses recorded in the CMBD. Methods: A cross-sectional validation study was conducted at Hospital Cl\u00ednico San Carlos (Madrid, Spain) including discharges from 2016\u20132023. Two age- and sex-matched samples of 384 admissions each (with and without T1DM coding, ICD-10 E10) were randomly selected. The gold standard was the confirmation of T1DM based on the diagnostic criteria established by the 2016 American Diabetes Association (ADA) consensus, which remained valid through 2025, verified by a detailed review of electronic health records (EHRs). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with 95% confidence intervals (CIs), and interobserver concordance was assessed with Cohen\u2019s kappa. Results: Of the 245,206 discharges, 1324 (0.54%) included a T1DM diagnosis. Validation showed a sensitivity of 100% (95% CI: 98.7\u2013100), specificity of 80.2% (95% CI: 76.4\u201383.5), PPV of 75.3% (95% CI: 70.7\u201379.3), and NPV of 100% (95% CI: 99.0\u2013100). Interobserver agreement was excellent (\u03ba = 0.869). Specificity declined with age, from 100% in patients &lt; 30 years to 60% in those \u2265 80 years, mainly due to misclassification with insulin-treated type 2 diabetes. Conclusions: T1DM diagnoses in the CMBD show very high validity and reliability in younger patients, supporting their use in epidemiological and clinical research, while complementary verification is advisable in older adults.<\/jats:p>","DOI":"10.3390\/jcm15062286","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:41Z","timestamp":1773742901000},"page":"2286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical Validation of Type 1 Diabetes Coding in Hospital Discharge Records Using ADA Criteria: Implications for Spanish and European Health Data Spaces"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5982-4635","authenticated-orcid":false,"given":"Rafael","family":"G\u00f3mez-Coronado-Mart\u00edn","sequence":"first","affiliation":[{"name":"Servicio de Admisi\u00f3n y Documentaci\u00f3n Cl\u00ednica, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Department of Public Health and Maternal & Child Health, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9450-4116","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Salinero-Fort","sequence":"additional","affiliation":[{"name":"Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community\u2014Hospital La Paz Institute for Health Research IdiPAZ, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-5181","authenticated-orcid":false,"given":"Ana","family":"L\u00f3pez-de-Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Public Health and Maternal & Child Health, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniala L.","family":"Weir","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5417-6747","authenticated-orcid":false,"given":"Carmen","family":"de Burgos-Lunar","sequence":"additional","affiliation":[{"name":"Department of Public Health and Maternal & Child Health, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Servicio de Medicina Preventiva, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1503\/cmaj.060244","article-title":"Type 1 diabetes: Pathogenesis and prevention","volume":"175","author":"Gillespie","year":"2006","journal-title":"CMAJ Can. 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Glob."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2286\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:40:31Z","timestamp":1773744031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062286"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062286","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}