• Damon C Scales, Jun Guan, Claudio M Martin, and Donald A Redelmeier.
• Department of Critical Care, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, G1 06, 2075 Bayview Avenue, Toronto, Ontario, Canada. damon.scales@utoronto.ca
• J Clin Epidemiol. 2006 Aug 1; 59 (8): 802-7.

Background And ObjectivesTo evaluate the accuracy of Ontario administrative health data for identifying intensive care unit (ICU) patients.Materials And MethodsRecords from the Critical Care Research Network patient registry (CCR-Net) were linked to the Ontario Health Insurance Program (OHIP) database and the Canadian Institute for Health Information (CIHI) database. The CCR-Net was considered the criterion standard for assessing the accuracy of different OHIP or CIHI codes for identifying ICU admission.ResultsThe highest positive predictive value (PPV) for ICU admission (91%) was obtained using a CIHI special care unit (SCU) code, but its sensitivity was poor (26%). A strategy based on a combination of CIHI SCU codes yielded a lower PPV (84%) but a higher sensitivity (92%). A strategy based purely on OHIP claims yielded further reductions in PPV (73%), gains in specificity (99%), and moderate sensitivity (56%). The highest sensitivity (100%) was obtained using a combination of CIHI and OHIP codes in exchange for poor PPV (32%).ConclusionsAdministrative databases can be used to identify ICU patients, but no single strategy simultaneously provided high sensitivity, specificity, and PPV. Researchers should consider the study purpose when selecting a strategy for health services research on ICU patients.

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