Validation of Chronic Inflammatory Demyelinating Polyradiculoneuropathy Coding in US Claims Data

ABSTRACT Purpose Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune condition of the peripheral nervous system. The validity of the CIDP diagnosis code in claims data is unclear. Methods We conducted a validation study testing the performance of claims‐based algori...

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Veröffentlicht in:Pharmacoepidemiology and drug safety Jg. 34; H. 3; S. e70123 - n/a
Hauptverfasser: Okonkwo, Joshua U., Williams, Erika K., Sadjadi, Reza, Schneeweiss, Sebastian, Anderson‐Smits, Colin, Ay, Hakan, Spalding, William, Anand, Priyanka, Lu, Zhigang, Lin, Kueiyu Joshua
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Chichester, UK John Wiley & Sons, Inc 01.03.2025
Wiley Subscription Services, Inc
Schlagworte:
Aged
Aged, 80 and over
Algorithms
Autoimmune diseases
chronic immune‐mediated acquired neuropathy
chronic inflammatory demyelinating polyradiculoneuropathy
claims‐based algorithm validation
Clinical Coding - standards
Clinical Coding - statistics & numerical data
Codes
Databases, Factual - statistics & numerical data
Demyelination
Diagnosis
Electronic Health Records - statistics & numerical data
Electronic medical records
Female
Humans
Immunoglobulins
Immunoglobulins, Intravenous - administration & dosage
Immunoglobulins, Intravenous - therapeutic use
Inflammation
Insurance Claim Review - statistics & numerical data
International Classification of Diseases - standards
Intravenous administration
intravenous immunoglobulin
Male
Medicare - statistics & numerical data
Middle Aged
Nervous system
Neuropathy
Patients
Peripheral nerves
Peripheral neuropathy
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - drug therapy
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - epidemiology
Predictive Value of Tests
United States - epidemiology
United States
chronic immune‐mediated acquired neuropathy
chronic inflammatory demyelinating polyradiculoneuropathy
claims‐based algorithm validation
intravenous immunoglobulin
ISSN:1053-8569, 1099-1557, 1099-1557
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Zusammenfassung:ABSTRACT Purpose Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune condition of the peripheral nervous system. The validity of the CIDP diagnosis code in claims data is unclear. Methods We conducted a validation study testing the performance of claims‐based algorithms in identifying CIDP cases, using electronic health record data from the Mass General Brigham Integrated Health Care System linked with Medicare claims data from 01/01/2008 to 12/31/2020. The algorithms require a record of intravenous immunoglobulin (IVIG) use and International Classification of Diseases 9th/10th Revision (ICD9/10) CIDP codes before (including) the date of IVIG use. The positive predictive values (PPVs) of each claims‐based algorithm were calculated against the reference standard for CIDP and chronic immune‐mediated acquired neuropathy established through chart review by two board‐certified neurologists using a standardized ion tool. Results The study cohort consisted of 140 patients (59 in the ICD9 and 81 in the ICD10 era). The PPV of the algorithm requiring at least one CIDP diagnosis code before IVIG use was 66.2% (95% confidence interval [CI], 58.0–74.3). The PPV improved to 71.2% (62.7–79.6) when requiring at least two CIDP codes before IVIG use. The PPV for patients with at least one CIDP code who met the European Academy of Neurology/Peripheral Nerve Society 2021 diagnostic criteria was 30.0% (22.1–37.9). Conclusion We found that a patient cohort identified using claims‐based CIDP diagnoses included a substantial number of patients with other chronic inflammatory acquired neuropathies not formally recognized as CIDP by clinical consensus criteria. Requiring two CIDP codes can improve PPVs.
Bibliographie:This study was funded by Takeda Pharmaceutical Company Limited.
Funding
Joshua U. Okonkwo and Erika K. Williams contributed equally to this work.
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ISSN:1053-8569
1099-1557
1099-1557
DOI:10.1002/pds.70123