Conflict of interest declared. See Conflict of Interest section.
Validation of claims-based diagnostic and procedure codes for cardiovascular and gastrointestinal serious adverse events in a commercially-insured population†
Version of Record online: 5 FEB 2010
Copyright © 2010 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 19, Issue 6, pages 596–603, June 2010
How to Cite
Wahl, P. M., Rodgers, K., Schneeweiss, S., Gage, B. F., Butler, J., Wilmer, C., Nash, M., Esper, G., Gitlin, N., Osborn, N., Short, L. J. and Bohn, R. L. (2010), Validation of claims-based diagnostic and procedure codes for cardiovascular and gastrointestinal serious adverse events in a commercially-insured population. Pharmacoepidem. Drug Safe., 19: 596–603. doi: 10.1002/pds.1924
- Issue online: 9 JUN 2010
- Version of Record online: 5 FEB 2010
- Manuscript Accepted: 10 DEC 2009
- Manuscript Revised: 7 DEC 2009
- Manuscript Received: 13 AUG 2009
- positive predictive value;
- myocardial infarction;
- ischemic stroke;
- upper GI bleed;
- claims data;
To validate administrative claims codes with medical chart review for myocardial infarction (MI), ischemic stroke, and severe upper gastrointestinal (UGI) bleed events in a large, commercially-insured US population.
These validation studies were part of a larger study examining the risk of MI, ischemic stroke, and severe UGI bleeds in patients receiving a new prescription of selective cyclooxygenase (COX)-2 inhibitors (coxibs) and non-over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs), between 1 July 2002 and 30 September 2004. Patients from the study cohort and other health plan members from the HealthCore Integrated Research DatabaseSM (HIRD) experiencing these events were selected for these studies. The positive predictive value (PPV) of each of the claims code algorithms, using medical chart review as the gold standard, was calculated.
Two hundred charts per event were abstracted. The PPV for MI was 88.4% (177/200; 95%CI, 83.2–92.5%); PPV for ischemic stroke was 87.4% (175/200; 95%CI, 82.0–91.7%); PPV for severe UGI bleed was 56.5% (109/193; 95%CI, 49.2–63.6%). Refining the ischemic stroke claims algorithm resulted in a PPV of 95.5% (95%CI, 91.0–98.2%); refining the claims algorithm for severe UGI bleed resulted in a PPV of 87.8% (95%CI, 78.7–94.0%).
The results suggest that, for certain adverse events, claims data can serve as the basis for pharmacoepidemiology research and drug safety surveillance in the US. Copyright © 2010 John Wiley & Sons, Ltd.