Validity of PTSD diagnoses in VA administrative data: Comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores

Amy A. Gravely, Andrea Cutting, Sean Nugent, Joseph Grill, Kathleen Carlson, Michele Spoont

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Little research has been done on the validity of posttraumatic stress disorder (PTSD) diagnoses that are found in Department of Veterans Affairs (VA) administrative data, even though they are often used in VA research. We compared PTSD diagnoses found in VA administrative data with PTSD Checklist (PCL) scores self-reported by 4,777 newly diagnosed participants in a national postal survey study. Using PCL scores of at least 50 as the gold standard, we compared positive predictive values (PPVs) for at least one versus at least two PTSD diagnoses (found within 4 months of the first) in VA administrative data overall and by subgroups of interest: age, sex, and clinic where first diagnosed. The overall PPV was 75% for at least one PTSD diagnosis and 82% for at least two PTSD diagnoses. Similarly, the PPV significantly increased for all subgroup analyses when at least two PTSD diagnoses were used. The increase in PPV was greatest for those first diagnosed in primary care and for those older than 65. To select a sample of veterans with more definitive PTSD from administrative data, researchers should select those veterans with at least two PTSD diagnoses as opposed to at least one.

Original languageEnglish (US)
Pages (from-to)21-30
Number of pages10
JournalJournal of Rehabilitation Research and Development
Volume48
Issue number1
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Veterans
Post-Traumatic Stress Disorders
Checklist
Aurothioglucose
Research
Primary Health Care
Research Personnel

Keywords

  • Administrative data
  • Algorithm
  • Electronic medical record
  • New episode
  • PCL
  • PPV
  • PTSD
  • PTSD Checklist
  • PTSD diagnosis
  • Sample
  • Sample inclusion criteria
  • Validity
  • Veterans health administration

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Validity of PTSD diagnoses in VA administrative data : Comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores. / Gravely, Amy A.; Cutting, Andrea; Nugent, Sean; Grill, Joseph; Carlson, Kathleen; Spoont, Michele.

In: Journal of Rehabilitation Research and Development, Vol. 48, No. 1, 2011, p. 21-30.

Research output: Contribution to journalArticle

@article{6920e9497cdc40ec8b38c23c8f3ce2e5,
title = "Validity of PTSD diagnoses in VA administrative data: Comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores",
abstract = "Little research has been done on the validity of posttraumatic stress disorder (PTSD) diagnoses that are found in Department of Veterans Affairs (VA) administrative data, even though they are often used in VA research. We compared PTSD diagnoses found in VA administrative data with PTSD Checklist (PCL) scores self-reported by 4,777 newly diagnosed participants in a national postal survey study. Using PCL scores of at least 50 as the gold standard, we compared positive predictive values (PPVs) for at least one versus at least two PTSD diagnoses (found within 4 months of the first) in VA administrative data overall and by subgroups of interest: age, sex, and clinic where first diagnosed. The overall PPV was 75{\%} for at least one PTSD diagnosis and 82{\%} for at least two PTSD diagnoses. Similarly, the PPV significantly increased for all subgroup analyses when at least two PTSD diagnoses were used. The increase in PPV was greatest for those first diagnosed in primary care and for those older than 65. To select a sample of veterans with more definitive PTSD from administrative data, researchers should select those veterans with at least two PTSD diagnoses as opposed to at least one.",
keywords = "Administrative data, Algorithm, Electronic medical record, New episode, PCL, PPV, PTSD, PTSD Checklist, PTSD diagnosis, Sample, Sample inclusion criteria, Validity, Veterans health administration",
author = "Gravely, {Amy A.} and Andrea Cutting and Sean Nugent and Joseph Grill and Kathleen Carlson and Michele Spoont",
year = "2011",
doi = "10.1682/JRRD.2009.08.0116",
language = "English (US)",
volume = "48",
pages = "21--30",
journal = "Journal of rehabilitation R&D",
issn = "0007-506X",
publisher = "Department of Veterans Affairs",
number = "1",

}

TY - JOUR

T1 - Validity of PTSD diagnoses in VA administrative data

T2 - Comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores

AU - Gravely, Amy A.

AU - Cutting, Andrea

AU - Nugent, Sean

AU - Grill, Joseph

AU - Carlson, Kathleen

AU - Spoont, Michele

PY - 2011

Y1 - 2011

N2 - Little research has been done on the validity of posttraumatic stress disorder (PTSD) diagnoses that are found in Department of Veterans Affairs (VA) administrative data, even though they are often used in VA research. We compared PTSD diagnoses found in VA administrative data with PTSD Checklist (PCL) scores self-reported by 4,777 newly diagnosed participants in a national postal survey study. Using PCL scores of at least 50 as the gold standard, we compared positive predictive values (PPVs) for at least one versus at least two PTSD diagnoses (found within 4 months of the first) in VA administrative data overall and by subgroups of interest: age, sex, and clinic where first diagnosed. The overall PPV was 75% for at least one PTSD diagnosis and 82% for at least two PTSD diagnoses. Similarly, the PPV significantly increased for all subgroup analyses when at least two PTSD diagnoses were used. The increase in PPV was greatest for those first diagnosed in primary care and for those older than 65. To select a sample of veterans with more definitive PTSD from administrative data, researchers should select those veterans with at least two PTSD diagnoses as opposed to at least one.

AB - Little research has been done on the validity of posttraumatic stress disorder (PTSD) diagnoses that are found in Department of Veterans Affairs (VA) administrative data, even though they are often used in VA research. We compared PTSD diagnoses found in VA administrative data with PTSD Checklist (PCL) scores self-reported by 4,777 newly diagnosed participants in a national postal survey study. Using PCL scores of at least 50 as the gold standard, we compared positive predictive values (PPVs) for at least one versus at least two PTSD diagnoses (found within 4 months of the first) in VA administrative data overall and by subgroups of interest: age, sex, and clinic where first diagnosed. The overall PPV was 75% for at least one PTSD diagnosis and 82% for at least two PTSD diagnoses. Similarly, the PPV significantly increased for all subgroup analyses when at least two PTSD diagnoses were used. The increase in PPV was greatest for those first diagnosed in primary care and for those older than 65. To select a sample of veterans with more definitive PTSD from administrative data, researchers should select those veterans with at least two PTSD diagnoses as opposed to at least one.

KW - Administrative data

KW - Algorithm

KW - Electronic medical record

KW - New episode

KW - PCL

KW - PPV

KW - PTSD

KW - PTSD Checklist

KW - PTSD diagnosis

KW - Sample

KW - Sample inclusion criteria

KW - Validity

KW - Veterans health administration

UR - http://www.scopus.com/inward/record.url?scp=79951483625&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951483625&partnerID=8YFLogxK

U2 - 10.1682/JRRD.2009.08.0116

DO - 10.1682/JRRD.2009.08.0116

M3 - Article

C2 - 21328160

AN - SCOPUS:79951483625

VL - 48

SP - 21

EP - 30

JO - Journal of rehabilitation R&D

JF - Journal of rehabilitation R&D

SN - 0007-506X

IS - 1

ER -