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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Health Services Research 1/2018

Validity of International Classification of Diseases (ICD) coding for dengue infections in hospital discharge records in Malaysia

BMC Health Services Research > Ausgabe 1/2018
Yuan-Liang Woon, Keng-Yee Lee, Siti Fatimah Zahra Mohd Anuar, Pik-Pin Goh, Teck-Onn Lim
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12913-018-3104-z) contains supplementary material, which is available to authorized users.



Hospitalization due to dengue illness is an important measure of dengue morbidity. However, limited studies are based on administrative database because the validity of the diagnosis codes is unknown. We validated the International Classification of Diseases, 10th revision (ICD) diagnosis coding for dengue infections in the Malaysian Ministry of Health’s (MOH) hospital discharge database.


This validation study involves retrospective review of available hospital discharge records and hand-search medical records for years 2010 and 2013. We randomly selected 3219 hospital discharge records coded with dengue and non-dengue infections as their discharge diagnoses from the national hospital discharge database. We then randomly sampled 216 and 144 records for patients with and without codes for dengue respectively, in keeping with their relative frequency in the MOH database, for chart review. The ICD codes for dengue were validated against lab–based diagnostic standard (NS1 or IgM).


The ICD-10-CM codes for dengue had a sensitivity of 94%, modest specificity of 83%, positive predictive value of 87% and negative predictive value 92%. These results were stable between 2010 and 2013. However, its specificity decreased substantially when patients manifested with bleeding or low platelet count.


The diagnostic performance of the ICD codes for dengue in the MOH’s hospital discharge database is adequate for use in health services research on dengue.
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