Positive predictive value of automated database records for diabetic ketoacidosis (DKA) in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid Study.
Positive predictive value of automated database records for diabetic ketoacidosis (DKA) in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid Study.
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DOI：
10.1186/1471-2288-11-157
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发表时间：
2011-11-23
影响因子：
4
通讯作者：
Ray WA
中科院分区：
文献类型：
--
作者：
Bobo WV;Cooper WO;Epstein RA Jr;Arbogast PG;Mounsey J;Ray WA
糖尿病酮症酸中毒（DKA）是儿童和青少年使用某些非典型抗精神病药物治疗的潜在危及生命的并发症。由于药物相关的DKA是罕见的，大型自动化的健康结果数据库可能是一个有价值的数据源进行药物流行病学研究DKA与暴露于个别抗精神病药物。但是，不存在DKA的有效计算机用例定义。我们试图评估计算机病例定义的阳性预测值（PPV），以检测DKA的事件病例，使用田纳西州医疗补助的自动记录作为数据源，医疗记录确认作为“金标准”。DKA的计算机病例定义是从田纳西州医疗补助计划6-24岁注册者中的抗精神病药物相关2型糖尿病回顾性队列研究（1996-2007）中开发的。从住院患者就诊索赔中确定了30例具有任何DKA诊断（ICD-9 250.1，ICD-10 E1x.1）的潜在病例。对病历进行审查，以确定其是否符合DKA的临床定义。在30例潜在病例中，27例（90%）被成功提取和裁定。其中，24例病例经病历审查证实（PPV 88.9%，95% CI 71.9 - 96.1%）。3例未确诊病例急性出现严重高血糖，但无酸中毒证据。使用我们的病例定义，可以在计算机化的Medicaid数据库中识别儿童和青少年糖尿病酮症酸中毒，这对于药物相关DKA是感兴趣结果的自动数据库研究可能有用。
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of treatment with some atypical antipsychotic drugs in children and youth. Because drug-associated DKA is rare, large automated health outcomes databases may be a valuable data source for conducting pharmacoepidemiologic studies of DKA associated with exposure to individual antipsychotic drugs. However, no validated computer case definition of DKA exists. We sought to assess the positive predictive value (PPV) of a computer case definition to detect incident cases of DKA, using automated records of Tennessee Medicaid as the data source and medical record confirmation as a "gold standard." The computer case definition of DKA was developed from a retrospective cohort study of antipsychotic-related type 2 diabetes mellitus (1996-2007) in Tennessee Medicaid enrollees, aged 6-24 years. Thirty potential cases with any DKA diagnosis (ICD-9 250.1, ICD-10 E1x.1) were identified from inpatient encounter claims. Medical records were reviewed to determine if they met the clinical definition of DKA. Of 30 potential cases, 27 (90%) were successfully abstracted and adjudicated. Of these, 24 cases were confirmed by medical record review (PPV 88.9%, 95% CI 71.9 to 96.1%). Three non-confirmed cases presented acutely with severe hyperglycemia, but had no evidence of acidosis. Diabetic ketoacidosis in children and youth can be identified in a computerized Medicaid database using our case definition, which could be useful for automated database studies in which drug-associated DKA is the outcome of interest.
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影响因子：
4.2
作者：
Ramaswamy, Krishnan;Kozma, Chris M.;Nasrallah, Henry
通讯作者：
Nasrallah, Henry
影响因子：
5
作者：
RAY, WA;GRIFFIN, MR
通讯作者：
GRIFFIN, MR
影响因子：
3.5
作者：
Wang, Z. H.;Kihl-Selstam, E.;Eriksson, J. W.
通讯作者：
Eriksson, J. W.
影响因子：
168.9
作者：
Morris, AD;Boyle, DIR;Newton, RW
通讯作者：
Newton, RW
DOI：
10.1023/a:1015228112495
发表时间：
2002-03-01
期刊：
Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
影响因子：
--
作者：
Jin, Hua;Meyer, Jonathan M;Jeste, Dilip V
通讯作者：
Jeste, Dilip V