Letter to the Editor: Comparative effectiveness of treatments for cerebral arteriovenous malformations

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To The Editor: Regarding the article by Davies et al.2 (Davies JM, Yanamadala V, Lawton MT: Comparative effectiveness of treatments for cerebral arteriovenous malformations: trends in nationwide outcomes from 2000 to 2009. Neurosurg Focus 33(1):E11, July 2012) describing trends in outcomes with treatment of cerebral arteriovenous malformations in the Nationwide Inpatient Sample, it should be noted that the code used to identify patients is not specific for cerebral arteriovenous malformations. The ICD-9-CM code 747.81 is defined as “anomalies of the cerebrovascular system.” Of patients identified with this code, 66% have a cerebral arteriovenous malformation, 13% have cavernous malformation, 10% have unruptured cerebral aneurysm, 8% have a dural arteriovenous fistula, 2% have a venous anomaly, and 1% have some other anomaly.1 Therefore, a significant portion of the patients described in the paper by Davies et al. underwent treatment of conditions other than arteriovenous malformation. This fact makes the results of the study by Davies et al. rather difficult to interpret. This nonspecific nature of ICD-9-CM code 747.81 seriously undermines its utility in conducting studies of cerebral arteriovenous malformations in large administrative databases.

Disclosure

The author reports no conflict of interest.

References

  • 1

    Berman MFStapf CSciacca RRYoung WL: Use of ICD-9 coding for estimating the occurrence of cerebrovascular malformations. AJNR Am J Neuroradiol 23:7007052002

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  • 2

    Davies JMYanamadala VLawton MT: Comparative effectiveness of treatments for cerebral arteriovenous malformations: trends in nationwide outcomes from 2000 to 2009. Neurosurg Focus 33:1Management of PlagiocephalyE112012

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Response

No response was received from the authors of the original article.

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Article Information

Please include this information when citing this paper: DOI: 10.3171/2012.8.FOCUS12293.

© AANS, except where prohibited by US copyright law.

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References

  • 1

    Berman MFStapf CSciacca RRYoung WL: Use of ICD-9 coding for estimating the occurrence of cerebrovascular malformations. AJNR Am J Neuroradiol 23:7007052002

    • Search Google Scholar
    • Export Citation
  • 2

    Davies JMYanamadala VLawton MT: Comparative effectiveness of treatments for cerebral arteriovenous malformations: trends in nationwide outcomes from 2000 to 2009. Neurosurg Focus 33:1Management of PlagiocephalyE112012

    • Search Google Scholar
    • Export Citation

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