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Of the received files, nine did not contain sufficient information and were excluded from analyses. Among the remaining 64 patients identified in the NPR as having an ICD-8/ICD-9/ICD-10 tic disorder, 59 were true-positive cases. There was 100% of agreement between the two raters regarding the presence or absence of a tic disorder (��=1). The remaining five cases were false positive cases, that is, they were not confirmed on chart review. This corresponds to an overall PPV for tic this website disorders of 0.92 (95% CI 0.82 to 0.97); all versions of ICD had high validity (table 4). Table?3 Number of requested, received and final patient files included in the analyses, by ICD version and county Table?4 Positive predictive values according to the two raters (senior psychiatrists) who assessed the NPR cases, by ICD version Further examination of individual ICD-10 subcodes for tic disorders (table 5) revealed that three of four patients who received a F95.1 (CTD) code in the register were diagnosed as having TS (F95.2) by the raters (motor and vocal tics could both be identified in the clinical histories). Unspecified tic disorder (F95.9) cases were diagnosed by the raters as either TS (F95.2), CTD (F95.1), unspecified tic disorder (F95.9) or transient tics (F95.0). Table?5 ICD-10 tic disorder cases When using the DSM-IV-TR criteria instead of ICD-10, there were three cases who were given another third position code in DSM-IV-TR based on an age of onset above 18?years of age. Two cases were assessed as ICD-10 F95.0 (transient) but would be F95.9 according to DSM-IV-TR, whereas one case of ICD-10 CTD would be F95.9 according to DSM-IV-TR. Validity and reliability of OCD codes We were able to obtain 75 of the requested 100 OCD files. Of the received files, seven did not contain sufficient information and were excluded from analyses. The final number of OCD cases included in the analyses was 68 (details in table 3). Among 68 patients identified in the NPR as having ICD-8/ICD-9/ICD-10 OCD, 48 (according to rater 1) or 49 (according to rater 2) were true-positive cases, indicating outstanding inter-rater reliability (��=0.98). The remaining 20 (rater 1) or 19 (rater 2) were false positive cases, that is, they were not confirmed on chart review. This corresponded to an overall PPV for OCD of 0.72 (95% CI 0.60 to 0.82) for rater 1 and 0.71 (95% CI 0.58 to 0.81) for rater 2 (table 4). There were marked differences between ICD versions; only ICD-10 codes had the desired level of validity (91�C96%). Table?6 lists the patients who were deemed to not fulfil the DSM-IV or ICD-10 criteria for OCD and the reasons for this. Table?6 OCD false positive cases False negatives We received 43 of the 50 requested epilepsy files and 44 of the 50 requested depression files, which we randomly mixed with the tic disorder and OCD files, respectively.