Identification of Acute Giant Cell Arteritis in Real-World Data Using Administrative Claims-Based Algorithms.
Identification of Acute Giant Cell Arteritis in Real-World Data Using Administrative Claims-Based Algorithms.
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DOI：
10.1002/acr2.11218
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发表时间：
2021-03
影响因子：
3.4
通讯作者：
Kim SC
中科院分区：
文献类型：
--
作者：
Lee H;Tedeschi SK;Chen SK;Monach PA;Kim E;Liu J;Pethoe-Schramm A;Yau V;Kim SC
本研究的目的是验证用于识别急性巨细胞动脉炎（GCA）的基于声明的算法，这将有助于生成关于比较有效性研究和流行病学研究的真实的世界证据。在通过GCA算法确定的患者中，我们进一步研究了是否可以通过使用索赔数据检测GCA发作。我们开发了五种基于索赔的算法，这些算法基于国际疾病分类第九版（ICD-9）诊断代码、专家就诊和使用与电子病历（2006 - 2014）相关联的Medicare Part A、B和D分发的药物。GCA的急性病例通过病历审查确定，使用治疗医生对GCA的诊断作为金标准。在确诊为急性GCA的患者中，我们评估了在初次诊断后的一年内是否发生GCA发作。每种算法识别的患者数量范围为220至896。算法的阳性预测值（PPV）范围为60.7%至84.8%。疾病特异性检查、多个诊断代码或专家访视的要求改善了PPV。最高PPV（84.8%）出现在一种算法中，该算法需要住院、急诊或门诊风湿病访视的两个或更多个GCA诊断代码，加上第二次ICD-9诊断日期前后14天的泼尼松等效剂量大于或等于40 mg/天，累积供应天数大于或等于14天。在确定为患有GCA的患者中，18.2%的患者有明确的发作证据，25%的患者有潜在的发作。基于索赔的算法需要来自住院、急诊或门诊风湿病就诊和大剂量糖皮质激素分发的两个或更多ICD-9诊断代码，这可能是在大型行政索赔数据库中识别急性GCA病例的有用工具。
The objective of this study was to validate claims‐based algorithms for identifying acute giant cell arteritis (GCA) that will help generate real‐world evidence on comparative effectiveness research and epidemiologic studies. Among patients identified by the GCA algorithm, we further investigated whether GCA flares could be detected by using claims data. We developed five claims‐based algorithms based on a combination of International Classification of Diseases, Ninth Revision (ICD‐9) diagnosis codes, specialist visits, and dispensed medications using Medicare Parts A, B, and D linked to electronic medical records (2006‐2014). Acute cases of GCA were determined by chart review using the treating physician’s diagnosis of GCA as the gold standard. Among the patients identified with acute GCA, we assessed if a GCA flare occurred during the year after initial diagnosis. The number of patients identified by each algorithm ranged from 220 to 896. Positive predictive values (PPVs) of the algorithms ranged from 60.7% to 84.8%. Requirement for disease‐specific workups, multiple diagnosis codes, or specialist visits improved the PPVs. The highest PPV (84.8%) was noted in an algorithm that required two or more diagnosis codes of GCA from inpatient, emergency department, or outpatient rheumatology visits plus a prednisone‐equivalent dose greater than or equal to 40 mg/day occurring 14 days before or after the second ICD‐9 diagnosis date, with the cumulative days’ supply greater than or equal to 14 days. Among patients identified as having GCA, 18.2% of patients had definite evidence of a flare and 25% had a potential flare. A claims‐based algorithm requiring two or more ICD‐9 diagnosis codes from inpatient, emergency department, or outpatient rheumatology visits and high‐dose glucocorticoid dispensing can be a useful tool to identify acute GCA cases in large administrative claims databases.
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影响因子：
--
作者：
Crowson, Cynthia S.;Matteson, Eric L.;Myasoedova, Elena;Michet, Clement J.;Ernste, Floranne C.;Warrington, Kenneth J.;Davis, John M., III;Hunder, Gene G.;Therneau, Terry M.;Gabriel, Sherine E.
通讯作者：
Gabriel, Sherine E.
影响因子：
2.1
作者：
Tomasson, G.;Bjornsson, J.;Merkel, P. A.
通讯作者：
Merkel, P. A.
影响因子：
4.9
作者：
Brekke, L. K.;Fevang, B. -T. S.;Gjesdal, C. G.
通讯作者：
Gjesdal, C. G.
影响因子：
--
作者：
SMITH, CA;FIDLER, WJ;PINALS, RS
通讯作者：
PINALS, RS
影响因子：
27.4
作者：
Smeeth, L.;Cook, C.;Hall, A. J.
通讯作者：
Hall, A. J.