• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>BMC Pulmonary Medicine >A cross-sectional study of the identification of prevalent asthma and chronic obstructive pulmonary disease among initiators of long-acting β-agonists in health insurance claims data
【24h】

A cross-sectional study of the identification of prevalent asthma and chronic obstructive pulmonary disease among initiators of long-acting β-agonists in health insurance claims data

机译：健康保险理赔数据中长效β-激动剂引发者中流行性哮喘和慢性阻塞性肺疾病的鉴定横断面研究

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background Claims data are potentially useful for identifying long-acting β-agonist (LABA) use by patients with asthma, a practice that is associated with increased mortality. We evaluated the accuracy of claims data for classifying prevalent asthma and chronic obstructive pulmonary disease (COPD) among initiators of LABAs. Methods This study included adult LABA initiators during 2005–2008 in a US commercial health plan. Diagnosis codes from the 6 months before LABA initiation identified potential asthma or COPD and a physician adjudicated case status using abstracted medical records. We estimated the positive predictive value (PPV) and 95% confidence intervals (CI) of covariate patterns for identifying asthma and COPD. Results We sought 520 medical records at random from 225,079 LABA initiators and received 370 (71%). The PPV for at least one asthma claim was 74% (CI 63–82), and decreased as age increased. Having at least one COPD claim resulted in a PPV of 82% (CI 72–89), and of over 90% among older patients, men, and recipients of inhaled anticholinergic drugs. Only 2% (CI 0.2–7.6) of patients with a claim for COPD alone were found to have both COPD and asthma, while 9% (CI 4–16) had asthma only. Twenty-one percent (CI 14–30) of patients with claims for both diagnoses had both conditions. Among patients with no asthma or COPD claims, 62% (CI 50–72) had no confirmed diagnosis and 29% (CI 19–39) had confirmed asthma. Conclusions Subsets of patients with asthma, COPD, and both conditions can be identified and differentiated using claims data, although categorization of the remaining patients is infeasible. Safety surveillance for off-label use of LABAs must account for this limitation.
机译：背景索赔数据可能对于确定哮喘患者使用长效β激动剂（LABA）有用，这种做法与死亡率增加有关。我们评估了索赔数据的准确性，以对LABA引发剂中的哮喘和慢性阻塞性肺疾病（COPD）进行分类。方法该研究在美国商业健康计划中纳入了2005-2008年间的成人LABA引发剂。 LABA启动前6个月的诊断代码确定了潜在的哮喘或COPD，并且医生使用摘要的医疗记录来判定病例状态。我们估计了用于识别哮喘和COPD的协变量模式的阳性预测值（PPV）和95％置信区间（CI）。结果我们从225,079个LABA发起者中随机检索了520份医疗记录，获得370份（71％）。至少一项哮喘声称的PPV为74％（CI 63–82），并且随着年龄的增长而降低。至少有一项COPD声明导致PPV为82％（CI 72–89），而在老年患者，男性和吸入抗胆碱能药物的接受者中，PPV超过90％。仅发现COPD的患者中只有2％（CI 0.2–7.6）同时患有COPD和哮喘，而只有9％（CI 4–16）仅患有哮喘。两种诊断均声称有疾病的患者中有21％（CI 14-30）。在没有哮喘或没有COPD主张的患者中，有62％（CI 50-72）未确诊，29％（CI 19-39）确诊为哮喘。结论使用索赔数据可以识别和区分哮喘，COPD和这两种疾病的患者亚群，尽管对其余患者进行分类是不可行的。标签外使用LABA的安全监视必须解决此限制。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号