Identification of rheumatoid arthritis in German claims data using different algorithms: Validation by cross-sectional patient-reported survey data.
ICD-10
claims data
diagnosis
electronic health records
validity
Journal
Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
28
10
2022
received:
30
05
2022
accepted:
31
10
2022
medline:
5
4
2023
pubmed:
10
11
2022
entrez:
9
11
2022
Statut:
ppublish
Résumé
To evaluate different algorithms for the identification of rheumatoid arthritis (RA) in claims data using patient-reported diagnosis as reference. Within longitudinal data from a large German statutory health insurance, we selected a random sample of persons with ICD-10 code for RA (M05/M06) in ≥2 quarters in 2013. The sample was stratified for age, sex, and M05/M06. Persons were asked to confirm RA diagnosis (gold standard), which was linked to claims data given consent. Analyses were weighted to represent the total RA population of the database. Positive predictive values (PPVs) and discriminative properties were calculated for different algorithms: ICD-10 code only, additional examination of inflammatory markers, prescription of specific medication, rheumatologist appointment, or combination of these. Of 6193 persons with a claims diagnosis of RA, 3184 responded (51%). Overall, PPV for the ICD-10 code was 81% (95% confidence interval 79%-83%) with 94% (92%-95%) for M05 and 76% (73%-79%) for M06. PPVs increased (with loss of case numbers) if inflammatory markers (82% [80%-84%]), rheumatology visits (85% [82%-87%]) or specific medication (89% [87%-91%]) had been used in addition. Specific medication had the best discriminative properties (diagnostic odds ratio of 3.0) among persons with RA diagnosis. The ICD-10 codes M05 and (less optimal) M06 have high PPVs and are valuable to identify RA in German claims data. Depending on the respective research question, researchers should use different criteria for identification of RA.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
517-525Informations de copyright
© 2022 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.
Références
Albrecht K, Callhoff J, Zink A. Long-term trends in rheumatology care: achievements and deficits in 25 years of the German national rheumatology database. Z Rheumatol. 2019;78(Suppl 2):65-72.
Richter A, Meissner Y, Strangfeld A, Zink A. Primary and secondary patient data in contrast: the use of observational studies like RABBIT. Clin Exp Rheumatol. 2016;34(5 Suppl 101):S79-S86.
Albrecht K, de Pablo P, Eidner T, et al. Association between RA disease activity and periodontitis defined by tooth loss: longitudinal and cross-sectional data from two observational studies. Arthritis Care Res (Hoboken). 2021. doi:10.1002/acr.24799
Hense S, Luque Ramos A, Callhoff J, Albrecht K, Zink A, Hoffmann F. Prevalence of rheumatoid arthritis in Germany based on health insurance data: regional differences and first results of the PROCLAIR study. Z Rheumatol. 2016;75(8):819-827.
Kienitz C, Grellmann C, Hapfelmeier J. Prevalence of rheumatoid arthritis in Germany: analysis of longitudinal data of statutory health insurance. Gesundheitswesen. 2021;83(5):367-373.
Strahl A, Schneider O, Frankenhauser-Mannuss J, et al. Prevalence, comorbidity and interdisciplinary treatment of rheumatoid arthritis - Insurance data on outpatient and inpatient care in Baden-Wurttemberg. Z Rheumatol. 2018;77(2):113-126.
Steffen A, Holstiege J, Goffrier B, Bätzing J. Epidemiologie der rheumatoiden Arthritis in Deutsch and - eine Analyse anhand bundesweiter vertragsärztlicher Abrechnungsdaten. Zentralinstitut für die kassenärztliche Versorgung in Deutschland (Zi). Versorgungsatlas-Bericht Nr. 17/08. Berlin; 2017. Accessed March 01, 2022. doi:10.20364/VA-17.08. http://www.versorgungsatlas.de/themen/alle-analysen-nach-datum-sortiert/?tab=6&uid=85
Grellmann C, Dombrowsky W, Fabricius V, Suruki R, Sheahan A, Joeres L. Epidemiology and treatment of patients with rheumatoid arthritis, psoriatic arthritis and psoriasis in Germany: a real-world evidence study. Adv Ther. 2021;38(1):366-385.
Chung CP, Rohan P, Krishnaswami S, McPheeters ML. A systematic review of validated methods for identifying patients with rheumatoid arthritis using administrative or claims data. Vaccine. 2013;31(Suppl 10):K41-K61.
Hanly JG, Thompson K, Skedgel C. The use of administrative health care databases to identify patients with rheumatoid arthritis. Open Access Rheumatol. 2015;7:69-75.
Widdifield J, Bernatsky S, Paterson JM, et al. Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists. Arthritis Care Res (Hoboken). 2013;65(10):1582-1591.
Widdifield J, Labrecque J, Lix L, et al. Systematic review and critical appraisal of validation studies to identify rheumatic diseases in health administrative databases. Arthritis Care Res (Hoboken). 2013;65(9):1490-1503.
Curtis JR, Xie F, Zhou H, Salchert D, Yun H. Use of ICD-10 diagnosis codes to identify seropositive and seronegative rheumatoid arthritis when lab results are not available. Arthritis Res Ther. 2020;22(1):242.
Widdifield J, Bombardier C, Bernatsky S, et al. An administrative data validation study of the accuracy of algorithms for identifying rheumatoid arthritis: the influence of the reference standard on algorithm performance. BMC Musculoskelet Disord. 2014;15:216.
Callhoff J, Luque Ramos A, Zink A, Hoffmann F, Albrecht K. The Association of low Income with functional status and disease burden in German patients with rheumatoid arthritis: results of a cross-sectional questionnaire survey based on claims data. J Rheumatol. 2017;44(6):766-772.
Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130-1139.
SAS Enterprise Guide 7.1. SAS Institute Inc. C, NC; 2017.
Benchimol EI, Smeeth L, Guttmann A, et al. The REporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Med. 2015;12(10):e1001885.
Almutairi K, Inderjeeth C, Preen DB, Keen H, Rogers K, Nossent J. The accuracy of administrative health data for identifying patients with rheumatoid arthritis: a retrospective validation study using medical records in Western Australia. Rheumatol Int. 2021;41(4):741-750.
Abbas S, Ihle P, Koster I, Schubert I. Estimation of disease incidence in claims data dependent on the length of follow-up: a methodological approach. Health Serv Res. 2012;47(2):746-755.
Kerola AM, Rollefstad S, Kazemi A, et al. Psoriatic arthritis, axial spondyloarthritis and rheumatoid arthritis in Norway: nationwide prevalence and use of biologic agents. Scand J Rheumatol. 2022;1-9. doi:10.1080/03009742.2021.1997436
Luque Ramos A, Hoffmann F. Differences in chronic back pain and joint disorders among health insurance funds: results of a cross-sectional study based on the data of the Socioeconomic Panel from 2013. Z Rheumatol. 2017;76(3):238-244.
Behr S, Schill W, Pigeot I. Does additional confounder information alter the estimated risk of bleeding associated with phenprocoumon use--results of a two-phase study. Pharmacoepidemiol Drug Saf. 2012;21(5):535-545.
Harrison S, Henderson J, Alderdice F, Quigley MA. Methods to increase response rates to a population-based maternity survey: a comparison of two pilot studies. BMC Med Res Methodol. 2019;19(1):65.
Callhoff J, Jacobs H, Albrecht K, Saam J, Zink A, Hoffmann F. Factors associated with survey non-response in a cross-sectional survey of persons with an axial spondyloarthritis or osteoarthritis claims diagnosis. Int J Environ Res Public Health. 2020;17(24). doi:10.3390/ijerph17249186
Guillemin F, Saraux A, Fardellone P, Guggenbuhl P, Behier JM, Coste J. Epidemiology Committe of the French Society of R: detection of cases of inflammatory rheumatic disorders: performance of a telephone questionnaire designed for use by patient interviewers. Ann Rheum Dis. 2003;62(10):957-963.