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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Validation of rheumatoid arthritis diagnoses in health care utilization data. | Kim et al. Arthritis Research Therapy 2011 13 R32 http arthritis-research.eom content 13 1 R32 RESEARCH ARTICLE Open Access Validation of rheumatoid arthritis diagnoses in health care utilization data 1.2 1 1 1 2 234 Seo Young Kim Amber Servi Jennifer M Polinski Helen Mogun Michael E Weinblatt Jeffrey N Katz Daniel H Solomon1 2 Abstract Introduction Health care utilization databases have been increasingly used for studies of rheumatoid arthritis RA . However the accuracy of RA diagnoses in these data has been inconsistent. Methods Using medical records and a standardized abstraction form we examined the positive predictive value PPV of several algorithms to define RA diagnosis using claims data A at least two visits coded for RA ICD-9 714 B at least three visits coded for RA and C at least two visits to a rheumatologist for RA. We also calculated the PPVs for the subgroups identified by these algorithms combined with pharmacy claims data for at least one disease-modifying anti-rheumatic drug DMARD prescription. Results We invited 9 482 Medicare beneficiaries with pharmacy benefits in Pennsylvania to participate 2 responded and consented for review of their medical records. There was no difference in characteristics between respondents and non-respondents. Using RA diagnosis per rheumatologists as the gold standard the PPVs were 55.7 for at least two claims coded for RA 65.5 for at least three claims for RA and 66.7 for at least two rheumatology claims for RA. The PPVs of these algorithms in patients with at least one DMARD prescription increased to 86.2 -88.9 . When fulfillment of 4 or more of the ACR RA criteria was used as the gold standard the PPVs of the algorithms combined with at least one DMARD prescriptions were 55.6 -60.7 . Conclusions To accurately identify RA patients in health care utilization databases algorithms that include both diagnosis codes and DMARD prescriptions are recommended. Introduction Large automated databases such as health care .
