Pneumococcal vaccination coverage among children with sickle cell anemia, sickle cell trait, and normal hemoglobin

Pediatric Blood & Cancer

2020

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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.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Grosse

Green

Pediatric Blood & Cancer

2020

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“…Administrative data included enrollment history and all paid claims for inpatient, outpatient, emergency department (ED), laboratory, and outpatient pharmacy services. Approximately 90% of children with SCA are enrolled in Medicaid at some point in time and consequently, we expect Medicaid claims data captured a large proportion of the children with SCA in these states …”

Section: Methodsmentioning

confidence: 99%

Hydroxyurea use among children with sickle cell anemia

Pediatric Blood & Cancer

Jary

Gondhi

et al. 2019

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This study describes hydroxyurea use among children ages 1 to 17 with sickle cell anemia (SCA) enrolled in at least one year of Medicaid in six states from 2005 to 2012. Administrative claims were used to summarize the number of days’ supply of hydroxyurea dispensed by state and year. A total of 7963 children with SCA contributed 22 424 person‐years. Among person‐years with greater than 30 days of hydroxyurea, only 18% received at least 300 days of hydroxyurea, which varied by state. Following updated recommendations for all children with SCA to be offered hydroxyurea, strategies to increase hydroxyurea adherence among this population are needed.

“…Michigan and NYS Medicaid programs may not be reflective of all of the nuances that exist between different state administrative claims databases, yet our study is strengthened by the consistency of results across two large, diverse Medicaid populations. Our results were also limited to children enrolled in Medicaid in a small timeframe; however, previous studies indicate that nearly 90 percent of children with SCA are enrolled in Medicaid at some point in time . Our study is only able to identify children with SCA that utilize health care.…”

Section: Discussionmentioning

confidence: 96%

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

Health Services Research

Madden

et al. 2020

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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.