Accuracy of Medicare claims data in identifying parkinsonism cases: Comparison with the Medicare Current Beneficiary Survey
Accuracy of Medicare claims data in identifying parkinsonism cases: Comparison with the Medicare Current Beneficiary Survey
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DOI：
10.1002/mds.21299
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发表时间：
2007-03-15
影响因子：
8.6
通讯作者：
Dick, Andrew W.
中科院分区：
文献类型：
--
作者：
Noyes, Katia;Liu, Hangsheng;Dick, Andrew W.
研究目的：管理数据库通常用于检查医疗服务的使用，研究人员依靠诊断代码来识别医疗条件。本研究评估了行政索赔的准确性，以确定帕金森氏症的情况下，自我报告的帕金森氏病（PD）。研究方法：参考病例是根据1992-2000年医疗保险当前受益人调查收集的自我报告的PD状态和PD药物使用情况确定的，该调查包含来自30，469名个体的72，922个观察结果。使用ICD-9 CM，从相应的医疗保险索赔中提取PD病例。我们比较了使用不同类型索赔获得的PD患病率。结果：当使用所有索赔时，敏感性最高（66%）。特异性均大于99%。当药物使用信息包括在金标准中时，敏感性降低，而特异性和阳性预测值（PPV）增加。使用更多的诊断代码提高了识别过程的灵敏度，但降低了PPV。结论：行政索赔可以提供相当准确和实用的方法来“规则”的PD患者。根据评估的目的，研究人员可能会考虑使用更多类别的索赔，以提高识别算法的灵敏度，或使用更少的诊断，以尽量减少假阳性病例的数量。(c)2007年，《社会运动》创刊。
Study Purpose: Administrative databases are commonly used to examine use of healthcare service, with researchers relying on diagnostic codes to identify medical conditions. This study evaluates the accuracy of administrative claims in identifying Parkinsonism cases compared to the self-reported Parkinson's disease (PD). Methods: The reference cases were identified based on the self-reported PD status and the use of PD drugs collected by the 1992-2000 Medicare Current Beneficiary Survey that contained 72,922 observations from 30,469 individuals. Using ICD-9 CM, cases with PD were extracted from the corresponding Medicare claims. We compared prevalence of PD obtained using different types of claims. Results: The sensitivities were the highest when all claims were used (66%). All the specificities were greater than 99%. When drug use information was included in the gold standard, the sensitivities became lower, while the specificities and positive predictive values (PPVs) increased. Using more diagnostic codes improved the sensitivity of the identification process but reduced PPVs. Conclusions: Administrative claims can provide fairly accurate and practical approach to "rule in" patients with PD. Depending on the purpose of evaluation, researchers may consider using more categories of claims to improve the sensitivity of the identification algorithm or use fewer diagnoses to minimize number of false positive cases. (c) 2007 Movement Disorder Society.