Prescription Analysis on Off-Label Drugs In Pediatric Patients Using The Claims Data of The National Health Insurance In Korea

Abstract

Objectives: The objective of this study was to describe racial differences in the prevalence of a cognitive impairment or dementia diagnosis, likelihood of chemoimmunotherapy utilization and subsequent survival in elderly diffuse large B-cell lymphoma (DLBCL) patients. MethOds: We conducted a retrospective cohort study using cancer data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. We identified Medicare beneficiaries with a first primary DLBCL diagnosis between 2001 and 2011. A validated algorithm for use with administrative claims data was used to determine presence of neurocognitive impairment or dementia diagnosis at baseline and throughout the study period based on International Classification of Diseases, Ninth Revision (ICD-9) and procedural codes. Results: Of the 10,626 Medicare beneficiaries identified with a DLBCL diagnosis, 410 (3.9%) patients also had evidence of a neurocognitive impairment or dementia diagnosis during the study period. The proportion of patients with comorbid neurocognitive impairment or dementia with DLBCL diagnosis was slightly higher among Non-Hispanic Black (6.1%) and Hispanic (4.6%) patients compared to non-Hispanic White (3.7%) and Asian/Pacific Islander (3.3%) patients. In multivariable models, patients with neurocognitive impairment or dementia had significantly lower odds of systemic treatment with chemo-immunotherapy (OR: 0.43; 95% CI: 0.34-0.54) with even lower odds of treatment among Black (OR: 0.16; 95% CI: 0.04-0.48) and Hispanic patients (OR: 0.17; 95% CI: 0.06-0.46). Poorer cancer-specific survival was observed among DLBCL patients with documented neurocognitive impairment or dementia (HR: 1.61, 95% CI: 1.43, 1.81), but this association was attenuated when adjusting for differences in curative treatment received (HR: 1.39, 95% CI: 1.24, 1.57). cOnclusiOns: There are racial differences in neurocognitive impairment and dementia and chemo-immunotherapy utilization among elderly DLBCL patients. Further research is needed to understand patient, caregiver and provider preferences in the care of lymphoma patients with these conditions.

Effect of Lipid-Testing Interval on Stoke Risk among Newly Diagnosed Dyslipidemia Patients Initiated on Statins

“…First, there could be an inaccuracy of the information in defining newly diagnosed dyslipidemia patients due to the nature of the claims database. However, previous studies for the diagnosis codes of the NHIS data have shown that 70% of the data from the NHIS database matched with those from patients’ medical records [35,36]. Second, we could not account for LDL –C levels due to the lack of information—not only the test for LDL-C, but also total cholesterol, TG and HDL-C levels not included in this study.…”

Antimicrobial Use and Carbapenem-Resistant Enterobacterales in Korea: A Nationwide Case-Control Study With Propensity Score Matching

“…However, approximately 70% of diagnostic codes were consistent with medical records. 40 41 In addition, since the risk factor analysis was performed only with the underlying diseases included in CCI, there may be limitations in the interpretation of the results, and further studies on important underlying diseases not included in CCI are needed in the future.…”

Is preeclampsia itself a risk factor for the development of metabolic syndrome after delivery?

“…According to a previous validation study that compared diagnoses from the database to the actual diagnoses documented in the patients' medical records, KNHI Claims Data had an 83.4% overall positive predictive value in the cases of hospitalized patients [3738]. The diagnostic codes were also more accurate for claims involving conditions with higher severity, such as preeclampsia [3940].…”