Agreement of immunosuppression regimens described in medicare pharmacy claims with the organ procurement and transplantation network survey
Agreement of immunosuppression regimens described in medicare pharmacy claims with the organ procurement and transplantation network survey
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DOI：
10.1681/asn.2006030258
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发表时间：
2006-08-01
影响因子：
13.6
通讯作者：
Lentine, Krista L.
中科院分区：
文献类型：
--
作者：
Stirnemann, Paula M.;Takemoto, Steven K.;Lentine, Krista L.
器官获取和移植网络 (OPTN) 收集有关免疫抑制药物使用的间歇性调查数据，这些数据经常作为研究措施进行研究。药房账单索赔可以提供免疫抑制剂随时间使用情况的准确衡量。本文的特点是 Medicare 药房对免疫抑制药物的索赔与 OPTN 报告一致。数据来自美国肾脏数据系统。参与者在 2000 年至 2001 年接受了肾移植，并在移植出院时以及移植后 6 个月和 1 年有 OPTN 记录和 Medicare 药房对免疫抑制药物的索赔。假设 OPTN 为“金标准”，则比较 OPTN 与指示药物使用的索赔（+/- 30 天的调查）的一致性 00，并计算索赔的敏感性、特异性和预测值。检查临床试验参与和方案改变作为不一致的解释。总共确定了 4357 名符合条件的受试者。观察的一致性范围从钙调神经磷酸酶抑制剂极好（kappa > 0.86）到辅助药物一般非常好（kappa = 0.49 至 0.75）到皮质类固醇较差（kappa < 0.15）。索赔证明阳性预测值较高 (>= 97%)，但阴性预测值较低 (
The Organ Procurement and Transplantation Network (OPTN) collects intermittent survey data on immunosuppressive medication use that are studied frequently as research measures. Pharmacy billing claims may provide an accurate measure of immunosuppression use over time. Herein is characterized the agreement of Medicare pharmacy claims for immunosuppressive medications with OPTN reports. Data were drawn from the United States Renal Data System. Participants received a kidney transplant in 2000 to 2001 and had an OPTN record and a Medicare pharmacy claim for an immunosuppressive drug at transplant discharge and 6 mo and 1 yr after transplantation. The concordance 00 of the OPTN and claims (+/- 30 d of survey) for indicated medication use was compared, and sensitivity, specificity, and predictive values for claims were computed, assuming OPTN as a "gold standard." Clinical trial participation and regimen changes were examined as explanations for discordance. A total of 4357 eligible subjects were identified. Concordance over observation ranged from excellent for calcineurin inhibitors (kappa > 0.86) to generally very good for adjunctive agents (kappa = 0.49 to 0.75) to poor for corticosteroids (kappa < 0.15). Claims demonstrated high positive predictive values (>= 97%) but low negative predictive values (