7 research outputs found
The Validity of Claims-Based Algorithms to Identify Serious Hypersensitivity Reactions and Osteonecrosis of the Jaw
<div><p>Validation of claims-based algorithms to identify serious hypersensitivity reactions and osteonecrosis of the jaw has not been performed in large osteoporosis populations. The objective of this project is to estimate the positive predictive value of the claims-based algorithms in older women with osteoporosis enrolled in Medicare. Using the 2006-2008 Medicare 5% sample data, we identified potential hypersensitivity and osteonecrosis of the jaw cases based on ICD-9 diagnosis codes. Potential hypersensitivity cases had a 995.0, 995.2, or 995.3 diagnosis code on emergency department or inpatient claims. Potential osteonecrosis of the jaw cases had ≥1 inpatient or outpatient physician claim with a 522.7, 526.4, 526.5, or 733.45 diagnosis code or ≥2 claims of any type with a 526.9 diagnosis code. All retrieved records were redacted and reviewed by experts to determine case status: confirmed, not confirmed, or insufficient information. We calculated the positive predictive value as the number of confirmed cases divided by the total number of retrieved records with sufficient information. We requested 412 potential hypersensitivity and 304 potential osteonecrosis of the jaw records and received 174 (42%) and 84 (28%) records respectively. Of 84 potential osteonecrosis of the jaw cases, 6 were confirmed, resulting in a positive predictive value (95% CI) of 7.1% (2.7, 14.9). Of 174 retrieved potential hypersensitivity records, 95 were confirmed. After exclusion of 25 records with insufficient information for case determination, the overall positive predictive value (95% CI) for hypersensitivity reactions was 76.0% (67.5, 83.2). In a random sample of Medicare data, a claim-based algorithm to identify serious hypersensitivity reactions performed well. An algorithm for osteonecrosis of the jaw did not, partly due to the inclusion of diagnosis codes that are not specific for osteoporosis of the jaw.</p></div
US Medicare Participant Selection—Hypersensitivity.
<p>US Medicare Participant Selection—Hypersensitivity.</p
Characteristics of Potential Cases by Contact Status.
<p><sup>a</sup> Contacted during Phase1 or Phase 2</p><p>Characteristics of Potential Cases by Contact Status.</p
Characteristics by Hypersensitivity Case Determination Status.
<p><sup>a</sup>16 cases were adjudicated on version1 case report form that did not include this question</p><p>Characteristics by Hypersensitivity Case Determination Status.</p
Comparison of Characteristics by ONJ Case Determination Status.
<p>Comparison of Characteristics by ONJ Case Determination Status.</p
US Medicare Participant Selection Flowchart—ONJ.
<p>US Medicare Participant Selection Flowchart—ONJ.</p
Translation of International Classification of Disease 9<sup>th</sup> Edition (ICD-9) Codes.
<p>Translation of International Classification of Disease 9<sup>th</sup> Edition (ICD-9) Codes.</p