Validation of claims-based algorithms for psoriatic arthritis
- Authors
- Lee, Hemin; Ford, Julia A.; Jin, Yinzhu; Cho, Soo-Kyung; Santiago Ortiz, Adrian J.; Tong, Angela Y.; Kim, Seoyoung C.
- Issue Date
- Apr-2020
- Publisher
- WILEY
- Keywords
- claims database; Medicare; pharmacoepidemiology; psoriasis; psoriatic arthritis
- Citation
- PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, v.29, no.4, pp.404 - 408
- Indexed
- SCIE
SCOPUS
- Journal Title
- PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
- Volume
- 29
- Number
- 4
- Start Page
- 404
- End Page
- 408
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/10555
- DOI
- 10.1002/pds.4950
- ISSN
- 1053-8569
- Abstract
- Purpose
An increasing number of new medications are being developed and approved for psoriatic arthritis (PsA). To generate real-world evidence on comparative safety and effectiveness of these drugs, a claims-based algorithm that can accurately identify PsA is greatly needed.
Methods
To identify patients with PsA, we developed seven claims-based algorithms based on a combination of diagnosis codes and medication dispensing using the claims data from Medicare parts A/B/D linked to electronic medical records (2012-2014). Two physicians independently conducted a chart review using the treating physician's diagnosis of PsA as the gold standard. We calculated the positive predictive value (PPV) and 95% confidence intervals of each algorithm.
Results
Of the total 2157 records identified by the seven algorithms, 45% of the records had relevant clinical data to determine the presence of PsA. The PPV of the algorithms ranged from 75.2% (algorithm 1: ≥2 diagnosis codes for PsA and ≥1 diagnosis code for psoriasis) to 88.6% (algorithm 7: ≥2 diagnosis codes for PsA with ≥1 code by rheumatologist and ≥1 dispensing for PsA medication). Having ≥2 diagnosis codes and ≥1 dispensing for PsA medications (algorithm 6) also had PPV of 82.4%.
Conclusions
All seven claims-based algorithms demonstrated a moderately high PPV of 75% to 89% in identifying PsA. The use of ≥2 diagnosis codes plus ≥1 prescription claim for PsA appears to be a valid and efficient tool in identifying PsA patients in the claims data, while broader algorithms based on diagnoses without a prescription claim also have reasonably good PPVs.
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