Commentary
Understanding the limitations of International Classification of Diseases (ICD) codes is important to improve the reliability of health system databases for epidemiological studies and health services research. KL Hayward et al. conducted a retrospective audit to explore the accuracy and limitations of the ICD-10-Australian Modification to detect NAFLD, metabolic risk factors and other aetiologies of chronic liver disease.
These codes underestimate the prevalence of NAFLD/NASH by 42.9%. They substantially underestimate obesity prevalence, due to lack of clear clinical documentation. In contrast, accuracy of codes to detect diabetes is excellent.
For the authors, changes may be required in the diagnosis codes, to better document the presence of NAFLD/NASH cirrhosis and obesity.
