Breathing (and Coding?) a Bit Easier

Mathai, Stephen C.; Mathew, Sherin

doi:10.1016/j.chest.2018.04.004

Cited by 15 publications

(10 citation statements)

References 35 publications

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“…416.0 to/from I27.0, and 416.8 to/from I27.2. 8 This conversion was performed to allow PAH and CTEPH patient identification according to both of these past coding conventions.…”

Section: Methodsmentioning

confidence: 99%

“…In PH, dedicated diagnosis codes for each group, including PAH and CTEPH, became available in the October 2017 ICD-10 update. 8 However, given the retrospective design of most claims database studies and a potential under-utilisation post-implementation, these new PH group-specific ICD-10 codes are still of limited usefulness for patient identification. Currently, identifying patients retrospectively relies on ICD-9 and pre-October 2017 ICD-10 codes, which differentiate only between primary (idiopathic/heritable PAH) and secondary PH (associated forms of PAH and PH groups 2–5), and do not appropriately reflect the current PH classifications.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of code‐based algorithms to identify pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients in large administrative databases

et al. 2020

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Large administrative healthcare (including insurance claims) databases are used for various retrospective real-world evidence studies. However, in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), identifying patients retrospectively based on administrative codes remains challenging, as it relies on code combinations ('algorithms') and the accuracy for patient identification of most of them is unknown. This study aimed to assess the performance of various algorithms in correctly identifying patients with PAH or CTEPH in administrative databases. A systematic literature review was performed to find publications detailing code-based algorithms used to identify PAH and CTEPH patients. PheValuator, a diagnostic predictive modelling tool, was applied to three US claims databases, yielding models that estimated the probability of a patient having the disease. These models were used to evaluate the performance characteristics of selected PAH and CTEPH algorithms. With increasing algorithm complexity, average positive predictive value increased (PAH: 13.4–66.0%; CTEPH: 10.3–75.1%) and average sensitivity decreased (PAH: 61.5–2.7%; CTEPH: 20.7–0.2%). Specificities and negative predictive values were high (≥97.5%) for all algorithms. Several of the algorithms performed well overall when considering all of these four performance parameters, and all algorithms performed with similar accuracy across the three claims databases studied, even though most were designed for patient identification in a specific database. Therefore, it is the objective of a study that will determine which algorithm may be most suitable; one- or two-component algorithms are most inclusive and three- or four-component algorithms identify most precise PAH or CTEPH populations, respectively.

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“…416.0 to/from I27.0, and 416.8 to/from I27.2. 8 This conversion was performed to allow PAH and CTEPH patient identification according to both of these past coding conventions.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of code‐based algorithms to identify pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients in large administrative databases

et al. 2020

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“…ICD-10-CM codes were not used in the reviewed studies, because the studies were conducted on claims data collected before October 2015. ICD-10-CM codes would be necessary for any claims-based studies conducted thereafter, and suggested ICD-10-CM codes for the diagnosis of PAH are provided in Table 3 (15). RHC and echocardiography were identified using Current Procedural Terminology (CPT) codes and ICD-9-CM procedure codes.…”

Section: How Is Pah Currently Being Identified In Claims-based Research?mentioning

confidence: 99%

“… Definition of abbreviations : ALK-1 = activin type I receptor kinase-like gene; BMPR2 = bone morphogenetic protein type 2; CAV1 = caveolin 1; ENG = endoglin; HIV = human immunodeficiency virus; ICD-10-CM = International Classification of Diseases, 10th Revision, Clinical Modification ; KCNK3 = potassium channel superfamily K member 3; PAH = pulmonary arterial hypertension; PH = pulmonary hypertension; SMAD9 = SMAD family member 9; WHO = World Health Organization.Adapted from Reference 15.…”

Section: How Is Pah Currently Being Identified In Claims-based Research?mentioning

confidence: 99%

Identifying Patients with Pulmonary Arterial Hypertension Using Administrative Claims Algorithms

et al. 2019

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Retrospective administrative claims database studies provide real-world evidence about treatment patterns, healthcare resource use, and costs for patients and are increasingly used to inform policy-making, drug formulary, and regulatory decisions. However, there is no standard methodology to identify patients with pulmonary arterial hypertension (PAH) from administrative claims data. Given the number of approved drugs now available for patients with PAH, the cost of PAH treatments, and the significant healthcare resource use associated with the care of patients with PAH, there is a considerable need to develop an evidence-based and systematic approach to accurately identify these patients in claims databases. A panel of pulmonary hypertension clinical experts and researchers experienced in retrospective claims database studies convened to review relevant literature and recommend best practices for developing algorithms to identify patients with PAH in administrative claims databases specific to a particular research hypothesis.

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“…), and I27.8 (congenital heart disease); WHO Group 3 could be split into I27.2(PH associated with interstitial lung disease, chronic obstructive pulmonary disease, sleep-disordered breathing, etc.) and I27.9(developmental lung diseases); WHO Group 2, Group 4, and Group 5 could be coded as I27.2 [ 29 ]. We found that the mortality rates from primary PH (I27.0) and pulmonary heart disease (unspecified, I27.9) had decreased significantly, while the mortality rate in other secondary PH (I27.2) and other specified pulmonary heart diseases (I27.8) had significantly increased, which was consistent with previous reports [ 12 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

International trends in pulmonary hypertension mortality between 2001 and 2019: Retrospective analysis of the WHO mortality database

Lin,

Jiang,

et al. 2024

Heliyon

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Breathing (and Coding?) a Bit Easier

Cited by 15 publications

References 35 publications

Evaluation of code‐based algorithms to identify pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients in large administrative databases

Evaluation of code‐based algorithms to identify pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients in large administrative databases

Identifying Patients with Pulmonary Arterial Hypertension Using Administrative Claims Algorithms

International trends in pulmonary hypertension mortality between 2001 and 2019: Retrospective analysis of the WHO mortality database

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