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Table 2 Performance characteristics of ICD-9-based algorithms for the diagnosis of avascular necrosis (AVN)

From: Administrative Algorithms to identify Avascular necrosis of bone among patients undergoing upper or lower extremity magnetic resonance imaging: a validation study

Algorithms

Sensitivity %, (95% CI)

Specificity %, (95% CI)

PPV %, (95% CI)

LR+ (95% CI)

A: ≥1 ICD-9 code for AVN

81.9 (72.0–89.5)

99.6 (99.4–99.7)

66.0 (56.0–75.1)

190.0 (134.5–268.5)

B: ≥2 ICD-9 codes for AVN at least 7 days apart

57.8 (46.5–68.6)

99.9 (99.8–99.9)

81.4 (69.1–90.3)

426.7 (229.9–792.1)

C: ≥2 ICD-9 codes for AVN at least 30 days apart

44.6 (33.7–55.9)

99.9 (99.8–99.9)

78.7 (64.3–89.3)

361.8 (186.2–703.1)

D: ≥3 ICD-9 codes for AVN at least 30 days apart

44.6 (33.7–55.9)

99.9 (99.8–100.0)

82.2 (67.9–92.0)

452.3 (217.3–941.4)

  1. All ICD-9 codes occurred within 6 months of MRI.
  2. Abbreviations: ICD-9 International Classification of Diseases, 9th version, CI Confidence Interval; PPV Positive Predictive Value, LR + Positive Likelihood Ratio
  3. The sensitivity of algorithm C is actually 44.578 and specificity of 99.877, whereas the sensitivity of algorithm D is 44.578 and the specificity is 99.901, accounting for the discrepancy in the observed likelihood ratios of algorithm C and D.