Positive Predictive Value of Benign Prostatic Hyperplasia and Acute Urinary Retention in the Danish National Patient Registry: A Validation Study

Abstract

Background and Aim

Benign prostatic hyperplasia comprises a significant burden to ageing men due to frequently associated lower urinary tract symptoms and the risk of developing serious complications, such as acute urinary retention. Healthcare databases are a valuable source of epidemiological research; however, continuous validation of definitions is imperative. We examined the positive predictive values of International Classification of Diseases, 10th Revision (ICD-10), diagnostic coding for benign prostatic hyperplasia and acute urinary retention in men in the Danish National Patient Registry.

Methods

We investigated a random sample of 100 men diagnosed with benign prostatic hyperplasia and 100 men diagnosed with acute urinary retention between 2011 and 2017 in the Central Denmark Region. Using medical record review as reference standard, we estimated the positive predictive value with corresponding 95% confidence intervals (CI) overall and stratified by age, type of hospital (university hospital vs regional hospital), type of hospital contact (inpatient, outpatient or emergency room), calendar year group (2011–2013, 2014–2017), and department (department of urology, geriatrics, endocrinology or emergency room).

Results

Medical records were available for all 200 sampled patients. We found an overall positive predictive value (PPV) of 95% (95% CI: 89–98%) for benign prostatic hyperplasia and 98% (95% CI: 93–99%) for acute urinary retention. The PPVs were consistent across age, type of hospital, type of hospital contact, calendar year group, and department.

Conclusion

The PPVs of ICD-10 codes for benign prostatic hyperplasia and acute urinary retention recorded in the Danish National Patient Registry are high.

Keywords:

• epidemiology
• benign prostatic hyperplasia
• acute urinary retention
• validity

Acknowledgments

The authors wish to thank the head of each of the involved departments for their cooperation and Henriette Kristoffersen for practical assistance.

Ethics Approval

This study was approved by The Danish Data Protection Agency (journal number: 2016-051-000001), the Danish Patient Safety Authority (reference number: 3-3013-2925/1) and by the Head of each involved departments. In accordance with Danish law governing analysis of registry data, no Ethics Committee approval was required.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Dr Thomas Johannesson Hjelholt reports grants from Novo Nordisk Foundation during the conduct of the study. The authors report no other potential conflicts of interest for this work.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.