Validation of claims‐based algorithms to identify patients with psoriasis

Purpose Accurately identifying patients with psoriasis (PsO) is crucial for generating real‐world evidence on PsO disease course and treatment utilization. Methods We developed nine claims‐based algorithms for PsO using a combination of the International Classification of Diseases (ICD)‐9 codes, spe...

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Bibliographic Details
Published in:	Pharmacoepidemiology and drug safety Vol. 30; no. 7; pp. 868 - 874
Main Authors:	Lee, Hemin, He, Mengdong, Cho, Soo‐Kyung, Bessette, Lily, Tong, Angela Y., Merola, Joseph F., Wegrzyn, Lani R., Kilpatrick, Ryan D., Kim, Seoyoung C.
Format:	Journal Article
Language:	English
Published:	Chichester, UK John Wiley & Sons, Inc 01.07.2021 Wiley Subscription Services, Inc
Subjects:	administrative claims data Algorithms claims‐based algorithm Codes Diagnosis Disease Electronic health records Electronic medical records PsO Psoriasis Steroid hormones validation Vitamin D administrative claims data PsO claims-based algorithm psoriasis validation
ISSN:	1053-8569, 1099-1557, 1099-1557
Online Access:	Get full text
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Summary:	Purpose Accurately identifying patients with psoriasis (PsO) is crucial for generating real‐world evidence on PsO disease course and treatment utilization. Methods We developed nine claims‐based algorithms for PsO using a combination of the International Classification of Diseases (ICD)‐9 codes, specialist visit, and medication dispensing using Medicare linked to electronic health records data (2013–2014) in two healthcare provider networks in Boston, Massachusetts. We calculated positive predictive value (PPV) and 95% confidence interval (CI) for each algorithm using the treating physician's diagnosis of PsO via chart review as the gold standard. Among the confirmed PsO cases, we assessed their PsO disease activity. Results The nine claims‐based algorithms identified 990 unique patient records. Of those, 918 (92.7%) with adequate information were reviewed. The PPV of the algorithms ranged from 65.1 to 82.9%. An algorithm defined as ≥1 ICD‐9 diagnosis code for PsO and ≥1 prescription claim for topical vitamin D agents showed the highest PPV (82.9%). The PPV of the algorithm requiring ≥2 ICD‐9 diagnosis codes and ≥1 prescription claim for PsO treatment excluding topical steroids was 81.1% but higher (82.5%) when ≥1 diagnosis was from a dermatologist. Among 411 PsO patients with adequate information on PsO disease activity in EHRs, 1.5–5.8% had no disease activity, 31.3–36.8% mild, and 26.9–35.1% moderate‐to‐severe across the algorithms. Conclusions Claims‐based algorithms based on a combination of PsO diagnosis codes and dispensing for PsO‐specific treatments had a moderate‐to‐high PPV. These algorithms can serve as a useful tool to identify patients with PsO in future real‐world data pharmacoepidemiologic studies.
Bibliography:	Funding information AbbVie; Aetion ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	1053-8569 1099-1557 1099-1557
DOI:	10.1002/pds.5229