Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims

Abstract

The claims-based algorithm appeared to successfully detect moderate-to-severe MS relapse. This validated definition can be applied to future claims-based MS studies.

Postmarketing Safety Profile of Subcutaneous Interferon Beta-1a Given 3 Times Weekly: A Retrospective Administrative Claims Analysis

“…The identification of a relapse episode was based on a validated algorithm previously used. 28 However, this algorithm is based on treatment received, and the threshold for intervention may vary among clinicians. Therefore, the true number of relapses may be underestimated.…”

“…Relapses were calculated using a validated algorithm that defined a MS-related relapse as consisting of either (a) a claim with an MS diagnosis in the primary position at any time during an inpatient hospitalization or (b) a claim with an MS diagnosis code in the primary or secondary position in an outpatient setting (including emergency room visits) in addition to a pharmacy or medical claim for a qualifying corticosteroid on the day of, or within 7 days after, the visit. 27,28 Health care utilization was measured in terms of number of inpatient hospitalizations and emergency room admissions. Prior DMD use and comedication use (concomitant corticosteroid use: yes/no), adherence status, and average length of time on therapy were also assessed.…”

Identifying Relapses in Multiple Sclerosis Patients through Administrative Data: A Validation Study in the Lazio Region, Italy

“…Identifying relapses through administrative claims databases is attractive because of wide data availability and low costs. To date many retrospective claims-based analyses have been carried out to evaluate drug effectiveness using relapse occurrence as outcome, as well as to estimate resource utilization and costs [12,28,29,30,31]. The poor agreement between episodes of relapse identified through HIS and medical charts should be taken into account in the interpretation of results from effectiveness studies based on the identification of relapses from administrative databases.…”

“…Administrative data relies on healthcare codes (International Classification of Diseases Ninth Revision [ICD-9]) indicative of diagnoses, but there is no diagnosis code specific to relapse. However, Ollendorf et al [11] proposed an operational claims-based algorithm for relapse identification that has been subsequently validated by Chastek et al [12]. This algorithm has been used in different studies that evaluated the occurrence of relapses in patients treated with drugs [13], the difference in relapse rates in patients with MS switching from Interferon to Fingolimod or Glatiramer Acetate [14] , and the incidence of relapses and the cost of care [15].…”

Increased Relapse Activity for Multiple Sclerosis Natalizumab Users Who Become Nonpersistent: A Retrospective Study

“…Relapse was defined as an MS-related hospitalization or MS-related emergency or outpatient visit with intravenous or oral steroid burst claim (methylprednisolone, prednisolone, prednisone, or adrenocorticotropic hormone) within 7 days. 34,35 Relapse-related cost was defined as the payer and subject paid claims for the associated relapse-related events. All costs were inflated to 2012 U.S. dollars using an average of the medical inflation rate over the study period.…”