Highlights
- •An expert panel compiled ICD-10 codes for ten chronic overlapping pain conditions
- •Natural language searches of medical records were used to validate these codes
- •An administrative database was used to quantify co-occurrence of the conditions
- •This set of codes is useful for administrative database research
Abstract
Chronic overlapping pain conditions (COPCs) are a set of painful chronic conditions
characterized by high levels of co-occurrence. It has been hypothesized that COPCs
co-occur in many cases because of common neurobiological vulnerabilities. In practice,
most research on COPCs has focused upon a single index condition with little effort
to assess comorbid painful conditions. This likely means that important phenotypic
differences within a sample are obscured. The International Classification of Diseases
(ICD) coding system contains many diagnostic classifications that may be applied to
individual COPCs, but there is currently no agreed upon set of codes for identifying
and studying each of the COPCs. Here we seek to address this issue through three related
projects 1) we first compile a set of ICD-10 codes from expert panels for ten common
COPCs, 2) we then use natural language searches of medical records to validate the
presence of COPCs in association with the proposed expert codes, 3) finally, we apply
the resulting codes to a large administrative medical database to derive estimates
of overlap between the ten conditions as a demonstration project. The codes presented
can facilitate administrative database research on COPCs.
Perspective
This article presents a set of ICD-10 codes that researchers can use to explore the
presence and overlap of COPCs in administrative databases. This may serve as a tool
for estimating samples for research, exploring comorbidities, and treatments for individual
COPCs, and identifying mechanisms associated with their overlap.
Keywords
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Article info
Publication history
Published online: May 30, 2019
Accepted:
May 20,
2019
Received in revised form:
April 29,
2019
Received:
December 19,
2018
Footnotes
Funding: This project were supported in part by National Institute of Diabetes and Digestive and Kidney Diseases, Grant number U01 DK092345-S1, National Institute of Dental and Craniofacial Research, Grant numbers K12 DE023574 and U01DE017018, National Institute of Neurological Disorders and Stroke, Grant number P01NS045685, and by the Office of Research on Women's Health, the National Institute of Health (NIH) Pain Consortium. The Authors gratefully acknowledge Linda Porter (NIH) and the COPC Taskforce Working Group.
Declaration of conflicts of interest: The authors declare no conflict of interest and no competing financial interests with this work. Dr. Williams is currently the Immediate past President of the American Pain Society; he has served as a consultant with Community Health Focus Inc
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© 2019 by United States Association for the Study of Pain, Inc.
