Administrative data identify sickle cell disease: A critical review of approaches in U.S. health services research.

Administrative data identify sickle cell disease: A critical review of approaches in U.S. health services research.
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DOI:
10.1002/pbc.28703
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发表时间:
2020-12
影响因子:
3.2
通讯作者:
Reeves SL
Reeves SL
中科院分区:
医学3区
文献类型:
--
作者:
Grosse SD;Green NS;Reeves SL

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为了识别患有镰状细胞病(SCD)的人并研究他们的医疗利用情况,研究人员可以使用链接到管理数据的临床记录,也可以使用独立管理数据库中的账单诊断代码。使用索赔数据库中的诊断代码正确识别临床上接受SCD管理的个人受到门诊接诊中账单代码准确性的限制。在这篇重要的综述中,我们评估了基于索赔的SCD病例查找算法在包含住院和门诊记录的独立管理数据库中的优势和局限性。使用临床记录和新生儿筛查确认SCD病例状态进行的验证研究发现,需要三个或更多非药房索赔或一个住院索赔加上两个或更多带有SCD代码的门诊索赔的算法在儿童和青少年中显示出可接受的准确性(阳性预测值和敏感性)。未来的研究可能会寻求评估病例发现算法在整个生命周期内的准确性。
To identify people living with sickle cell disease (SCD) and study their healthcare utilization, researchers can either use clinical records linked to administrative data or use billing diagnosis codes in stand-alone administrative databases. Correct identification of individuals clinically managed for SCD using diagnosis codes in claims databases is limited by the accuracy of billing codes in outpatient encounters. In this critical review, we assess the strengths and limitations of claims-based SCD case-finding algorithms in stand-alone administrative databases that contain both inpatient and outpatient records. Validation studies conducted using clinical records and newborn screening for confirmation of SCD case status have found that algorithms that require three or more nonpharmacy claims or one inpatient claim plus two or more outpatient claims with SCD codes show acceptable accuracy (positive predictive value and sensitivity) in children and adolescents. Future studies might seek to assess the accuracy of case-finding algorithms over the lifespan.
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