Pulmonary Arterial Hypertension: Too Complex for Physicians, Too Complex for ICD Diagnosis Codes

摘要

We read with interest the recent article “Accuracy of Algorithms to Identify Pulmonary Arterial Hypertension in Administrative Data: A Systematic Review” by Gillmeyer et?alsup1/sup in this issue of CHEST. The authors characterize the ample limitations and poor diagnostic accuracy posed by analyzing electronic health records of patients with purported pulmonary hypertension. Intriguing arguments made on the results of their meta-analysis are “a need for revision of ICD diagnosis codes to allow discrimination between different WHO PH groups” and the incorporation of “PAH-specific medications in the case definition.” While we applaud the authors for bringing forth this tremendous problem in the field of pulmonary hypertension, we would recommend caution in assuming these changes would improve the accuracy of pulmonary arterial hypertension (PAH) diagnosis.