AI Article Synopsis
- Public health surveillance for drug overdoses often relies on health records, but it's unclear how many nonfatal overdoses are captured this way compared to those reported by individuals themselves.
- A study linked survey data from Veterans regarding self-reported overdoses to their health records, revealing that diagnostic codes for overdoses had low sensitivity across various substances.
- The findings indicate that health records may miss a significant number of overdoses, suggesting that incorporating self-reported data in clinical settings could improve overdose monitoring and intervention strategies.
Article Abstract
Background And Objectives: Public health surveillance for overdose sometimes depends on nonfatal drug overdoses recorded in health records. However, the proportion of total overdoses identified through health record systems is unclear. Comparison of overdoses from health records to those that are self-reported may provide insight on the proportion of nonfatal overdoses that are not identified.
Methods: We conducted a cohort study linking survey data on overdose from a national survey of Veterans to United States Department of Veterans Affairs (VA) health records, including community care paid for by VA. Self-reported overdose in the prior 3 years was compared to diagnostic codes for overdoses and substance use disorders in the same time period.
Results: The sensitivity of diagnostic codes for overdose, compared to self-report as a reference standard for this analysis, varied by substance: 28.1% for alcohol, 23.1% for sedatives, 12.0% for opioids, and 5.5% for cocaine. There was a notable concordance between substance use disorder diagnoses and self-reported overdose (sensitivity range 17.9%-90.6%).
Discussion And Conclusions: Diagnostic codes in health records may not identify a substantial proportion of drug overdoses. A health record diagnosis of substance use disorder may offer a stronger inference regarding the size of the population at risk. Alternatively, screening for self-reported overdose in routine clinical care could enhance overdose surveillance and targeted intervention.
Scientific Significance: This study suggests that diagnostic codes for overdose are insensitive. These findings support consideration of alternative approaches to overdose surveillance in public health.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617764 | PMC |
| http://dx.doi.org/10.1111/ajad.13327 | DOI Listing |
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