Joshua U Okonkwo, Erika K Williams, Reza Sadjadi, Sebastian Schneeweiss, Colin Anderson-Smits, Hakan Ay, William Spalding, Priyanka Anand, Zhigang Lu, Kueiyu Joshua Lin
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引用次数: 0
Abstract
Purpose: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune condition of the peripheral nervous system. The validity of the CIDP diagnosis code in claims data is unclear.
Methods: We conducted a validation study testing the performance of claims-based algorithms in identifying CIDP cases, using electronic health record data from the Mass General Brigham Integrated Health Care System linked with Medicare claims data from 01/01/2008 to 12/31/2020. The algorithms require a record of intravenous immunoglobulin (IVIG) use and International Classification of Diseases 9th/10th Revision (ICD9/10) CIDP codes before (including) the date of IVIG use. The positive predictive values (PPVs) of each claims-based algorithm were calculated against the reference standard for CIDP and chronic immune-mediated acquired neuropathy established through chart review by two board-certified neurologists using a standardized abstraction tool.
Results: The study cohort consisted of 140 patients (59 in the ICD9 and 81 in the ICD10 era). The PPV of the algorithm requiring at least one CIDP diagnosis code before IVIG use was 66.2% (95% confidence interval [CI], 58.0-74.3). The PPV improved to 71.2% (62.7-79.6) when requiring at least two CIDP codes before IVIG use. The PPV for patients with at least one CIDP code who met the European Academy of Neurology/Peripheral Nerve Society 2021 diagnostic criteria was 30.0% (22.1-37.9).
Conclusion: We found that a patient cohort identified using claims-based CIDP diagnoses included a substantial number of patients with other chronic inflammatory acquired neuropathies not formally recognized as CIDP by clinical consensus criteria. Requiring two CIDP codes can improve PPVs.
期刊介绍：
The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report.
Particular areas of interest include:
design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology;
comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world;
methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology;
assessments of harm versus benefit in drug therapy;
patterns of drug utilization;
relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines;
evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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