Identifying Sickle Cell Disease Cases Using Administrative Claims

Reeves, Sarah L.; Garcia, E Blank de; Kleyn, Mary; Housey, Michelle; Stottlemyer, Robin; Lyon-Callo, Sarah; Dombkowski, Kevin J.

doi:10.1016/j.acap.2014.02.008

Cited by 73 publications

(102 citation statements)

References 28 publications

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“…Second, we used a single claim to define CP and osteoporosis. Previous validation studies have shown that two or more claims for a medical condition tend to improve accurate identification of that medical condition . However, accurately identifying medical conditions depends on the number of years for the study period and the medical condition examined .…”

Section: Discussionmentioning

confidence: 99%

“…Previous validation studies have shown that two or more claims for a medical condition tend to improve accurate identification of that medical condition . However, accurately identifying medical conditions depends on the number of years for the study period and the medical condition examined . A single claim‐based definition for identifying a pediatric‐onset disability and osteoporosis performs better compared with other medical conditions, with positive predictive values of approximately 80% and up to 92%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, insurance coverage will be used to stratify results. Using a single medical claim to identify a pediatric‐onset disability using administrative claims data has shown approximately 80% positive predictive value and 99% sensitivity …”

Section: Methodsmentioning

confidence: 99%

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Osteoporosis Epidemiology Among Adults With Cerebral Palsy: Findings From Private and Public Administrative Claims Data

2019

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Individuals with cerebral palsy (CP) have an increased risk for the early development of osteoporosis; however, little is known about the epidemiology of osteoporosis for adults with CP, which is vital to inform clinical practice for osteoporosis prevention, treatment, and management. The purpose of this cross‐sectional study was to determine sex‐stratified prevalence of osteoporosis among adults with CP, as compared with adults without CP. Data from 2016 were extracted from Optum Clinformatics Data Mart (private insurance administrative claims data) and a random 20% sample from the fee‐for‐service Medicare (public insurance administrative claims data). Diagnostic codes were used to identify CP and osteoporosis diagnoses. Sex‐stratified prevalence of osteoporosis was compared between adults with and without CP for the following age groups: 18 to 30, 31 to 40, 41 to 50, 51 to 60, 61 to 70, and >70 years of age. The overall prevalence of osteoporosis was 4.8% for adults without CP (n = 8.7 million), 8.4% for privately insured adults with CP (n = 7,348), and 14.3% for publicly insured adults with CP (n = 21,907). Women and men with CP had a higher prevalence of osteoporosis compared with women and men without CP for all age groups. Finally, publicly insured women and men with CP had a higher prevalence of osteoporosis compared with privately insured women and men with CP for all age groups, except for the similar prevalence among the 18‐ to 30‐year age group. These findings suggest that osteoporosis is more prevalent among adults with CP compared with adults without CP. Study findings highlight the need for earlier screening and preventive medical services for osteoporosis management among adults with CP. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Osteoporosis Epidemiology Among Adults With Cerebral Palsy: Findings From Private and Public Administrative Claims Data

2019

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“…Specific types of health services were considered, as these services can have different predictive values for identifying cases in other chronic conditions . Counts of claims or service types ranged from at least one to at least 3; previous findings indicate that little specificity would be gained by requiring additional claims and would result in loss of sensitivity . Definitions with varying lengths between outpatient visits were also considered, consistent with other administrative claims‐based definitions for chronic conditions .…”

Section: Methodsmentioning

confidence: 99%

“…Diagnosis codes, which are contained in administrative claims databases, are commonly used to identify children with chronic diseases such as asthma, diabetes, and inflammatory bowel disease . Several studies have demonstrated that administrative claims using ICD‐9‐CM diagnosis codes can be used to accurately identify children with sickle cell disease . However, these definitions are subject to two limitations in assessing health services among children with SCA: (a) identification of children with sickle cell disease more broadly as opposed to children with SCA; and (b) use of ICD‐9‐CM diagnosis codes.…”

Section: Introductionmentioning

confidence: 99%

Performance of ICD‐10‐CM diagnosis codes for identifying children with Sickle Cell Anemia

Reeves

Madden

et al. 2020

Health Services Research

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Objective To develop, test, and validate the performance of ICD‐10‐CM claims‐based case definitions for identifying children with sickle cell anemia (SCA). Data Sources Medicaid administrative claims (2016) for children <18 years with potential SCA (any D57x diagnosis code) and newborn screening records from Michigan and New York State. Study Design This study is a secondary data analysis. Data Collection/Extraction Methods Using specific SCA‐related (D5700, D5701, and D5702) and nonspecific (D571) diagnosis codes, 23 SCA case definitions were applied to Michigan Medicaid claims (2016) to identify children with SCA. Measures of performance (sensitivity, specificity, area under the ROC curve) were calculated using newborn screening results as the gold standard. A parallel analysis was conducted using New York State Medicaid claims and newborn screening data. Principal Findings In Michigan Medicaid, 1597 children had ≥1 D57x claim; 280 (18 percent) were diagnosed with SCA. Measures of performance varied, with sensitivities from 0.02 to 0.97 and specificities from 0.88 to 1.0. The case definition of ≥1 outpatient visit with a SCA‐related or D571 code had the highest area under the ROC curve, with a sensitivity of 95 percent and specificity of 92 percent. The same definition also had the highest performance in New York Medicaid (n = 2454), with a sensitivity of 94 percent and specificity of 86 percent. Conclusions Children with SCA can be accurately identified in administrative claims using this straightforward case definition. This methodology can be used to monitor trends and use of health services after transition to ICD‐10‐CM.

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Transcranial Doppler Screening Among Children and Adolescents With Sickle Cell Anemia

et al. 2016

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IMPORTANCE With transcranial Doppler (TCD) screening, we can identify children and adolescents with sickle cell anemia who are at the highest risk of stroke. An accurate claims-based method for identifying children and adolescents with sickle cell anemia was recently developed and validated that establishes the necessary groundwork to enable large population-based assessments of health services utilization among children and adolescents with sickle cell anemia using administrative claims data. OBJECTIVE To assess the feasibility of using administrative claims data to identify and describe the receipt of TCD screening among children and adolescents with sickle cell anemia and to characterize opportunities for intervention. DESIGN, SETTING, AND PARTICIPANTS Retrospective cross-sectional study using Medicaid claims data from 2005 to 2010. Medicaid claims data were obtained from the following states: Florida, Illinois, Louisiana, Michigan, South Carolina, and Texas. Children and adolescents 2 to 16 years of age with sickle cell anemia were identified by the presence of 3 or more Medicaid claims with a diagnosis of sickle cell anemia within a calendar year (2005-2010). A total of 4775 children and adolescents contributed 10 787 person-years throughout the study period. Data were analyzed in 2015. A subset of children and adolescents enrolled for 2 or more consecutive years was identified to examine potential predictors of TCD screening, which included age, sex, previous receipt of TCD screening, state of residence, and health services utilization (well-child visits, outpatient visits, emergency department visits, and inpatient visits). MAIN OUTCOMES AND MEASURES Receipt of TCD screening was assessed by year and state. Using logistic regression with generalized estimating equations, we included associated predictors in a multivariable model to estimate odds of TCD screening. RESULTS For a total of 4775 children and adolescents 2 to 16 years of age, TCD screening rates increased over the 6-year study period from 22% to 44% (P < .001); rates varied substantially across states. A subset of 2388 children and adolescents with sickle cell anemia (50%) was enrolled for 2 or more consecutive years. Each year of increasing age was associated with 3% lower odds of TCD screening (odds ratio, 0.97 [95% CI, 0.95-0.98]; P = .002). Previous receipt of TCD screening (odds ratio, 2.44 [95% CI, 2.11-2.81]; P < .001) and well-child visits (odds ratio, 1.10 [95% CI, 1.03-1.18]; P = .007) were associated with higher odds of receiving a TCD screening. CONCLUSIONS AND RELEVANCE Despite national recommendations, TCD screening rates remain low. Successful strategies to improve TCD screening rates may capitalize on the numerous health care interactions among children and adolescents with sickle cell anemia.

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Identifying Sickle Cell Disease Cases Using Administrative Claims

Abstract: This definition can be used to facilitate a more accurate identification of children with SCD in future studies. Further investigation is necessary to determine whether this method translates to other populations besides Michigan Medicaid-insured children.

Cited by 73 publications

References 28 publications

Osteoporosis Epidemiology Among Adults With Cerebral Palsy: Findings From Private and Public Administrative Claims Data

Osteoporosis Epidemiology Among Adults With Cerebral Palsy: Findings From Private and Public Administrative Claims Data

Performance of ICD‐10‐CM diagnosis codes for identifying children with Sickle Cell Anemia

Transcranial Doppler Screening Among Children and Adolescents With Sickle Cell Anemia

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