Identifying the Mechanisms of Missingness for Unspecified Diabetic Retinopathy Disease Severity in the Electronic Health Record: An IRIS® Registry Analysis

Research Lead:

Mike Mbagwu, Zhongdi Chu, Durga Borka, Alex Koshta, Nisarg Shah, Aracelis Torres, Hylton Kalvaria, Flora Lum, Matthew T Roe, Theodore Leng


Observational studies of diabetic retinopathy (DR) using electronic health record data often determine disease severity using International Classification of Disease (ICD) codes. We investigated the mechanism of missingness for DR severity based on ICD coding using the American Academy of Ophthalmology IRIS® Registry. We included all patient encounters in the registry with a DR ICD-9 or ICD-10 code between January 1, 2014 and June 30, 2021. Demographic, clinical, and practice-level characteristics were compared between encounters with specified and unspecified disease severity. Practices were divided into quartiles based on the proportion of clinical encounters with unspecified DR severity. Encounters with unspecified disease severity were associated with significantly older patient age, better visual acuity, and lower utilization of ophthalmic procedures. Higher volume practices and retina specialist practices had lower proportions of clinical encounters with unspecified disease severity. Results strongly suggest that DR disease severity related to ICD coding is missing not at random.

Ab Interno Minimally Invasive Glaucoma Surgery Combined with Cataract Surgery and Cataract Surgery Alone: IRIS®️ Registry Study

April 7, 2024
Read More

Comparison of Methods of Clinical Trial Emulation Utilizing Data from the Comparison of AMD Treatment Trial (CATT) and the IRISⓇ Registry

April 3, 2024
Read More

Multi-registry analysis of patients with multiple sclerosis and neuromyelitis optica to improve capture of demographic data and compare visual outcomes

February 11, 2024
Read More

Vitreoretinal Specialist Use of Ancillary Testing: An IRIS®️ Registry Analysis

October 20, 2023
Read More

Evaluation of treatment and switching patterns for Dry Eye Disease medications using linked EHR and Claims data

October 19, 2023
Read More

Vitreoretinal Specialist Use of Ancillary Testing: An IRIS® Registry Analysis

October 17, 2023
Read More

Impact of Anti-VEGF Treatment and Patient Characteristics on Vision Outcomes in nAMD: Up to 6-Year Analysis of the AAO IRIS® Registry

October 10, 2023
Read More

24 Month Real-World Study of Intraocular Pressure and Medication Reduction in Ab Interno Microinvasive Glaucoma Surgery Combined with Cataract Surgery Compared with Cataract Surgery Only: An IRIS® Registry Study

September 20, 2023
Read More

Enhancing assessment of demographics and visual outcomes in MS and NMO patients through combination of neurology and ophthalmology based registries

July 31, 2023
Read More

Talk to a Qdata Expert

Take a minute to submit your contact information and one of our team members will reach out to you.