Evidence map›Paper›PMID 40086063›Full record

ArticleSeizure2025

Validation of ICD codes for the identification of patients with functional seizures.

Jonah Fox, Hannah E Branstetter, Robert Havranek, Murli Mishra, Nicholas S Mallett

Abstract readValidation Study
In one paragraph

Article in Seizure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jonah FoxDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States. Electronic address: jonah.fox@vumc.org.
Hannah E BranstetterDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
Robert HavranekDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
Murli MishraDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
Nicholas S MallettDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
NCATS NIH HHS UL1 TR000445
6 · The paper itself

Abstract

objectiveTo evaluate the validity of ICD-9-CM and ICD-10 codes for the identification of patients with functional seizures (FS).

methodsWe evaluated the charts of 800 patients including 400 in an institution wide sample and 400 in an epilepsy monitoring unit (EMU) sample. Half of the patients from each sample came from 2012-2013 and 2022-2023 since ICD-9-CM codes and ICD-10 codes were exclusively used in these respective periods. The charts of each patient were manually reviewed and evaluated for the presence of epilepsy and FS. Based on the 2013 International League Against Epilepsy (ILAE) Nonepileptic Seizures Task Force guidelines we determined whether a patient had either presumptive (clinically established or documented) or probable/possible FS. We evaluated ICD-9-CM codes 300.11 (conversion disorder) and 780.39 (other convulsions) as well as ICD-10 codes F44.5 (conversion disorder or functional neurological disorder with seizures or convulsions) and R56.9 (unspecified convulsions). The positive predictive value (PPV) of each ICD code was calculated in the institution wide sample and the sensitivity, specificity, PPV and negative predictive values (NPV) were calculated in the EMU sample.

resultsIn the institution wide sample, F44.5 had a PPV of 74.0 % (64.6-81.6) for presumptive FS and 80.0 % (71.1-86.7) when probable/possible FS patients were included. The code 300.11 had a PPV of 52.0 % (42.3-61.5) for presumptive FS and 59.0 % (49.2-68.1) when probable/possible FS patients were included. Codes R56.9 and 780.39 had PPVs that were equal to or less than 20 %. In the EMU sample, the code F44.5 had a sensitivity, specificity, PPV and NPV of 67.1 % (56.3-76.3), 95.8 % (90.5-98.2), 91.7 % (81.9-96.4), and 80.7 % (73.4-86.4), respectively for presumptive FS. The code 300.11 had a sensitivity, specificity, PPV and NPV of 30.1 % (20.8-41.4), 95.3 % (90.1-97.8), 78.6 % (60.5-89.8), and 70.4 % (63.1-76.7), respectively for presumptive FS. The codes R56.9 and 780.39 performed poorly. SIGNIFICANCE: ICD codes had a mixed performance when used to identify patients with FS. ICD-10 code F44.5 appeared to perform the best overall.

Indexed as

EpilepsyInternational Classification of DiseasesSeizuresAdolescentAdultAgedFemaleHumansMaleMiddle AgedSensitivity and SpecificityYoung AdultAdministrative databaseDiagnosis codesPsychogenic non-epileptic seizuresSensitivitySpecificity

Identifiers

PMID40086063
PMCPMC13169336

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.