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: | Eva Ng, Yan Ding, Florence T. Wang, Fei Xue, Cathy W. Critchlow, David D. Dore |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Positive predictive value
medicine.medical_specialty Databases Factual Drug-Related Side Effects and Adverse Reactions Administrative data computer.software_genre Dermatologic events Insurance Claim Review 030207 dermatology & venereal diseases 03 medical and health sciences Postmenopausal osteoporosis 0302 clinical medicine International Classification of Diseases Predictive Value of Tests Health care medicine Humans 030212 general & internal medicine Adverse effect Osteoporosis Postmenopausal Aged Hypocalcemia Database business.industry lcsh:Public aspects of medicine Health Policy Public health Medical record lcsh:RA1-1270 Emergency department Exanthema Middle Aged Rash Confidence interval Female Diagnosis code medicine.symptom business computer Research Article |
| Zdroj: | BMC Health Services Research, Vol 18, Iss 1, Pp 1-6 (2018) BMC Health Services Research |
| ISSN: | 1472-6963 |
| DOI: | 10.1186/s12913-018-3016-y |
| Popis: | 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. Electronic supplementary material The online version of this article (10.1186/s12913-018-3016-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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