Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register

Figures & data

Figure 1 Patient with ONJ lesion in the right maxilla.

Abbreviation: ONJ, osteonecrosis of the jaw.

Table 1 PPVs and 95% CIs of diagnoses related to ONJ as recorded in the Swedish Patient Register and validated against medical records

ONJ related diagnoses in the patient register	Potential cases	Confirmed cases in the medical record review
	Number	Number	PPVa (%)	95% CIb
Any ONJ related diagnosis	83	15	18	10–28
Periapical abscess with sinus (ICD-10 K04.6)	20	0	0	0–17
Inflammatory conditions of jaws (ICD-10 K10.2)	43	7	16	7–31
Alveolitis of jaws (ICD-10 K10.3)	7	0	0	0–41
Idiopathic aseptic necrosis of bone (ICD-10 M87.0)	0	–	–	–
Osteonecrosis due to drugs (ICD-10 M87.1)	6	5	83	36–100
Osteonecrosis due to previous trauma (ICD-10 M87.2)	0	–	–	–
Other secondary osteonecrosis (ICD-10 M87.3)	0	–	–	–
Other osteonecrosis (ICD-10 M87.8)	3	0	0	0–71
Osteonecrosis, unspecified (ICD-10 M87.9)	0	–	–	–
Mixed groupsc
Inflammatory conditions of jaws (ICD-10 K10.2) + osteonecrosis due to drugs (ICD-10 M87.1)	3	3	100	29–100
Inflammatory conditions of jaws (ICD-10 K10.2) + other osteonecrosis (ICD-10 M87.8)	1	0	0	0–98

Notes:

a Number of confirmed cases divided by number of potential cases;

b confidence interval calculated using binomial exact method;

c potential cases with two different ICD-10 codes included in the algorithm.

Abbreviations: PPV, positive predictive value; CI, confidence interval; ONJ, osteonecrosis of the jaw; ICD, the International Classification of Diseases and Related Health Problems.

Table 2 Characteristics of patients with a confirmed diagnosis of ONJ by medical record review (data from medical records)

Characteristics	Number (%)
Total number of cases	15
Mean age, years (SD)	74 (10)
Age groups, years
55–65	3 (20%)
66–75	4 (27%)
>75	8 (53%)
Malignancies (medical records and register data)
Breast cancer	3 (20%)
Myeloma	1 (7%)
Other	2 (13%)
Comorbidities
Diabetes mellitus type 2	2 (13%)
Hypertension	3 (20%)
Rheumatoid arthritis	1 (7%)
Polymyalgia rheumatica	1 (7%)
Medication
Bisphosphonates	14 (93%)
Cytostatics	3 (20%)
Glucocorticoids	4 (27%)
Teriparatide	1 (7%)
Proton-pump inhibitors	2 (13%)
Dentures	2 (13%)
Dentoalveolar surgery	11 (73%)
Dental trauma	1 (7%)
Localization
Right maxilla	4 (27%)
Left maxilla	4 (27%)
Left mandible	6 (40%)
Right mandible	6 (40%)

Abbreviation: SD, standard deviation; ONJ, osteonecrosis of the jaw.