{
  "abstract": "Background/Objectives: Hospital discharge data are increasingly reused for research and within health data spaces, but their value depends on accurate diagnostic coding. The validity of type 2 diabetes mellitus (T2DM) coding in the Spanish hospital discharge database (CMBD) had not been assessed across a whole regional network. We aimed to quantify the precision and completeness of E11 coding across the public hospital network of the Region of Madrid. Methods: We conducted a retrospective validation study in the public hospitals of the Region of Madrid (2016–2025). In each of four hospital complexity groups, we selected admissions with and without an ICD-10-ES E11 code, matched by age and sex (787 and 781 analysed). The reference standard was the American Diabetes Association criteria, checked in health records. Predictive values were estimated directly; sensitivity, specificity and prevalence were reconstructed for the whole population, adjusting for sex and age. Results: Of 4,707,924 discharges, 918,797 (19.5%) had a T2DM code. The positive predictive value was 94.2% (95% CI: 92.1–96.0), the negative predictive value 94.0% (91.3–96.3), specificity 98.5% (98.0–99.0) and sensitivity 79.3% (72.4–86.2), a lower bound. The estimated prevalence of T2DM among discharges was 23.2%, against 19.5% coded; about 226,000 admissions with T2DM had no code. Only the positive predictive value differed between hospital groups (p = 0.006). Conclusions: The E11 code is highly precise but incomplete: it is reliable for building cohorts, whereas counts based on it underestimate the number of cases by about one in five.",
  "abstract_shown": true,
  "affiliations": [
    "Servicio de Admisión y Documentación Clínica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain",
    "Department of Public Health and Maternal & Child Health, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain",
    "Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CS Utrecht, The Netherlands",
    "Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute, 28029 Madrid, Spain",
    "Research Network on Health Services and Chronic Diseases (REDISSEC), Carlos III Health Institute, 28029 Madrid, Spain",
    "Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community Group—Hospital La Paz Institute for Health Research IdiPAZ, 28046 Madrid, Spain",
    "Community and Home Care Unit, Faculty of Biomedical and Health Sciences, Alfonso X El Sabio University, Villanueva de la Cañada, 28691 Madrid, Spain",
    "Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Rafael Gómez-Coronado-Martín",
      "orcid": "0000-0001-5982-4635"
    },
    {
      "affs": [
        0
      ],
      "name": "Ana Chacón-García",
      "orcid": "0009-0001-4491-8898"
    },
    {
      "affs": [
        1
      ],
      "name": "Ana López-de-Andrés",
      "orcid": "0000-0001-5551-5181"
    },
    {
      "affs": [
        3,
        4,
        5,
        6
      ],
      "name": "Miguel A. Salinero-Fort",
      "orcid": "0000-0002-9450-4116"
    },
    {
      "affs": [
        2
      ],
      "name": "Daniala L. Weir"
    },
    {
      "affs": [
        1,
        3,
        7
      ],
      "name": "Carmen de Burgos-Lunar",
      "orcid": "0000-0001-5417-6747"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/23bz169ssp0b9.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197717",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666438/?tool=EBI",
  "id": "23bz169ssp0b9",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13666438",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3605|Medical Coding and Health Information"
    ]
  ],
  "openalex": "W7220831247",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666438/pdf/?tool=EBI",
  "pmcid": "PMC13666438",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/23bz169ssp0b9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "PMC:PMC13666438",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13666438"
    },
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15197717",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/19/7717"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Validating Type 2 Diabetes Diagnoses Across the Madrid Hospital Network: Evidence for Secondary Use of the CMBD in the European Health Data Space",
  "title_text": "Validating Type 2 Diabetes Diagnoses Across the Madrid Hospital Network: Evidence for Secondary Use of the CMBD in the European Health Data Space",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/23bz169ssp0b9",
  "venue": "Journal of clinical medicine",
  "versions": []
}