Journal of Evaluation in Clinical Practice

Accuracy of clinical coding of pleural empyema: A validation study

Early View

Abstract Introduction Routinely recorded coding data are increasingly being used for clinical research, but the quality of that data is often variable. The clinical coding of pleural empyema has not been studied. If data are not accurately recorded, linking coding data through, for example, Hospital Episode Statistic data (HES), will lead to inappropriate conclusions. Methods We extracted the coding data for a year from three hospitals in the Southwest of England, UK: One large district general hospital, one tertiary pleural referral centre, and one thoracic surgical centre. We verified and validated this coding to ensure its accuracy. To assess the sensitivity of coding, we then verified the coded cases against a cohort of proven empyema patients from a recent observational study. Results One hundred eighty‐two patients with a coded diagnosis of pleural empyema were extracted. In 158 of these patients, the diagnosis was correct clinically, with a positive predictive value of 86%. In the cohort of 25 patients with a known clinical diagnosis of empyema, 18 were coded as empyema, a sensitivity of 72%. There was no significant difference in coding between hospitals. Conclusion In the centres studied, empyema coding was generally good (>85% accuracy), although some cases were miscoded. Using codes for elective admissions helped to differentiate post‐operative from community acquired empyema. It is likely empyema is under rather than over‐recorded in HES data.

Related Topics

Related Publications

Related Content

Site Footer


This website is provided by John Wiley & Sons Limited, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ (Company No: 00641132, VAT No: 376766987)

Published features on are checked for statistical accuracy by a panel from the European Network for Business and Industrial Statistics (ENBIS)   to whom Wiley and express their gratitude. This panel are: Ron Kenett, David Steinberg, Shirley Coleman, Irena Ograjenšek, Fabrizio Ruggeri, Rainer Göb, Philippe Castagliola, Xavier Tort-Martorell, Bart De Ketelaere, Antonio Pievatolo, Martina Vandebroek, Lance Mitchell, Gilbert Saporta, Helmut Waldl and Stelios Psarakis.