Validation of claims-based algorithms for identification of high-grade cervical dysplasia and cervical cancer

ABSTRACT Background High‐grade cervical dysplasia or cervical intraepithelial neoplasia grade 2 or worse has been widely used as a surrogate endpoint in cervical cancer screening or prevention trials. Methods To identify high‐grade cervical dysplasia and cervical cancer, we developed claims‐based al...

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Veröffentlicht in:	Pharmacoepidemiology and drug safety Jg. 22; H. 11; S. 1239 - 1244
Hauptverfasser:	Kim, Seoyoung C., Gillet, Victoria G., Feldman, Sarah, Lii, Huichuan, Toh, Sengwee, Brown, Jeffrey S., Katz, Jeffrey N., Solomon, Daniel H., Schneeweiss, Sebastian
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Chichester Blackwell Publishing Ltd 01.11.2013 Wiley Wiley Subscription Services, Inc
Schlagworte:	Adult Algorithms Biological and medical sciences Carcinoma in Situ - diagnosis Carcinoma in Situ - pathology Cervical cancer cervical dysplasia Cervical Intraepithelial Neoplasia - diagnosis Cervical Intraepithelial Neoplasia - pathology claims data Clinical Coding Databases, Factual - statistics & numerical data Electronic Health Records - statistics & numerical data Female Female genital diseases Gynecology. Andrology. Obstetrics Humans Medical coding Medical sciences Medical screening pharmacoepidemiology Predictive Value of Tests Tumors Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - pathology validity Women Young Adult Validation Premalignant lesion Identification Malignant tumor Uterine cervix Algorithm Epidemiology Female genital diseases High grade pharmacoepidemiology Validity Cervical dysplasia Uterine cervix diseases Cervical cancer Cancer High malignancy claims data cervical dysplasia validity cervical cancer
ISSN:	1053-8569, 1099-1557, 1099-1557
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Zusammenfassung:	ABSTRACT Background High‐grade cervical dysplasia or cervical intraepithelial neoplasia grade 2 or worse has been widely used as a surrogate endpoint in cervical cancer screening or prevention trials. Methods To identify high‐grade cervical dysplasia and cervical cancer, we developed claims‐based algorithms that incorporated a combination of diagnosis and procedure codes using the billing data in an electronic medical records database and assessed the validity of the algorithms in an independent administrative claims database. We calculated the positive predictive value (PPV) with the 95% confidence interval (CI) of each algorithm, using new cytologic or pathologic diagnosis of cervical intraepithelial neoplasia 2 or 3, carcinoma in situ, or cervical cancer as the gold standard. Results Having ≥1 diagnosis code for high‐grade cervical dysplasia or cervical cancer had a PPV of 57.1% (95%CI, 54.7–59.5%). By requiring ≥2 diagnoses for high‐grade cervical dysplasia or cervical cancer, separated by 7–30 days, the PPV increased to 60.2% (95%CI, 53.9–66.1%). At least two diagnoses and a procedure code within a month from the first diagnosis date yielded a PPV of 80.7% (95%CI, 73.6–86.2%). The algorithms had greater PPVs in identifying prevalent high‐grade cervical dysplasia or cervical cancer. Overall, the PPVs of these algorithms were similar or slightly lower in the external claims data than in the sample used to derive the algorithms. Conclusions Use of ≥2 diagnosis codes in combination with a procedure code appears to be a valid tool for studying high‐grade cervical dysplasia and cervical cancer in both electronic medical record and administrative claims databases. Copyright © 2013 John Wiley & Sons, Ltd.
Bibliographie:	ArticleID:PDS3520 istex:5F8EEB23344B223C6CBF1CA39803431E2CA47E9E ark:/67375/WNG-MZWQ3V8Q-R ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Reprint Request to: Seoyoung C Kim, MD, MSCE, Address: 1620 Tremont Street, Suite 3030, Boston MA 02120, USA
ISSN:	1053-8569 1099-1557 1099-1557
DOI:	10.1002/pds.3520