ICD-10 anaphylaxis algorithm and the estimate of vaccine-attributable anaphylaxis incidence in Medicare
| Autor: | Jeffrey A. Kelman, Michael Wernecke, Thomas E. MaCurdy, Kerry J. Welsh, Arnstein Lindaas, Deepa Arya, Julie Loc, Michael Lu, Ravi Goud, Yoganand Chillarige, Deborah L Thompson |
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| Rok vydání: | 2021 |
| Předmět: |
Allergic reaction
Population Medicare International Classification of Diseases Claims data medicine Humans education Fee-for-service Anaphylaxis Aged Vaccines education.field_of_study General Veterinary General Immunology and Microbiology business.industry Incidence Incidence (epidemiology) Medical record Public Health Environmental and Occupational Health ICD-10 medicine.disease United States Infectious Diseases Molecular Medicine business Algorithm Algorithms |
| Zdroj: | Vaccine. 39:5368-5375 |
| ISSN: | 0264-410X |
| Popis: | Background Anaphylaxis is a rare, serious allergic reaction. Its identification in large healthcare databases can help better characterize this risk. Objective To create an ICD-10 anaphylaxis algorithm, estimate its positive predictive values (PPVs) in a post-vaccination risk window, and estimate vaccination-attributable anaphylaxis rates in the Medicare Fee For Service (FFS) population. Methods An anaphylaxis algorithm with core and extended portions was constructed analyzing ICD-10 anaphylaxis claims data in Medicare FFS from 2015 to 2017. Cases of post-vaccination anaphylaxis among Medicare FFS beneficiaries were then identified from October 1, 2015 to February 28, 2019 utilizing vaccine relevant anaphylaxis ICD-10 codes. Information from medical records was used to determine true anaphylaxis cases based on the Brighton Collaboration’s anaphylaxis case definition. PPVs were estimated for incident anaphylaxis and the subset of vaccine-attributable anaphylaxis within a 2-day post-vaccination risk window. Vaccine-attributable anaphylaxis rates in Medicare FFS were also estimated. Results The study recorded 66,572,128 vaccinations among 21,685,119 unique Medicare FFS beneficiaries. The algorithm identified a total of 190 suspected anaphylaxis cases within the 2-day post-vaccination window; of these 117 (62%) satisfied the core algorithm, and 73 (38%) additional cases satisfied the extended algorithm. The core algorithm’s PPV was 66% (95% CI [56%, 76%]) for identifying incident anaphylaxis and 44% (95% CI [34%, 56%]) for vaccine-attributable anaphylaxis. The vaccine-attributable anaphylaxis incidence rate after any vaccination was 0.88 per million doses (95% CI [0.67, 1.16]). Conclusion The ICD-10 claims algorithm for anaphylaxis allows the assessment of anaphylaxis risk in real-world data. The algorithm revealed vaccine-attributable anaphylaxis is rare among vaccinated Medicare FFS beneficiaries. |
| Databáze: | OpenAIRE |
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