Predictive values of diagnostic codes for identifying serious hypocalcemia and dermatologic adverse events among women with postmenopausal osteoporosis in a commercial health plan database.

Autor: Wang FT; Optum Epidemiology, 1325 Boylston Street, Suite 1000, Boston, MA, 02215, USA. florence.wang@optum.com., Xue F; Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA., Ding Y; Optum Epidemiology, 1325 Boylston Street, Suite 1000, Boston, MA, 02215, USA., Ng E; Optum Epidemiology, 1325 Boylston Street, Suite 1000, Boston, MA, 02215, USA., Critchlow CW; Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA., Dore DD; Optum Epidemiology, 1325 Boylston Street, Suite 1000, Boston, MA, 02215, USA.; Brown University School of Public Health, Providence, RI, 02912, USA.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2018 Apr 10; Vol. 18 (1), pp. 263. Date of Electronic Publication: 2018 Apr 10.
DOI: 10.1186/s12913-018-3016-y
Abstrakt: Background: Post-marketing safety studies of medicines often rely on administrative claims databases to identify adverse outcomes following drug exposure. Valid ascertainment of outcomes is essential for accurate results. We aim to quantify the validity of diagnostic codes for serious hypocalcemia and dermatologic adverse events from insurance claims data among women with postmenopausal osteoporosis (PMO).
Methods: We identified potential cases of serious hypocalcemia and dermatologic events through ICD-9 diagnosis codes among women with PMO within claims from a large US healthcare insurer (June 2005-May 2010). A physician adjudicated potential hypocalcemic and dermatologic events identified from the primary position on emergency department (ED) or inpatient claims through medical record review. Positive predictive values (PPVs) and 95% confidence intervals (CIs) quantified the fraction of potential cases that were confirmed.
Results: Among 165,729 patients with PMO, medical charts were obtained for 40 of 55 (73%) potential hypocalcemia cases; 16 were confirmed (PPV 40%, 95% CI 25-57%). The PPV was higher for ED than inpatient claims (82 vs. 24%). Among 265 potential dermatologic events (primarily urticaria or rash), we obtained 184 (69%) charts and confirmed 128 (PPV 70%, 95% CI 62-76%). The PPV was higher for ED than inpatient claims (77 vs. 39%).
Conclusion: Diagnostic codes for hypocalcemia and dermatologic events may be sufficient to identify events giving rise to emergency care, but are less accurate for identifying events within hospitalizations.
Databáze: MEDLINE
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