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Data validation is an essential part of a comprehensive assessment. Validation is confirming or verifying and opening the door to gathering more assessment data as it clarifies vague or unclear data. The process of checking and verifying the collected information is called data validation. The primary purpose of data validation is to ensure data is as free from error, bias, and misinterpretation as possible.
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Methodologies for Validation of Diagnoses in Real-World Data: BONES-A Case Study.

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This study validated coding accuracy for fifth metatarsal fracture nonunion using health care claims. Results show high accuracy, with 95.2% of patients having confirmatory claims for nonunion diagnosis.

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Area of Science:

  • Orthopedics
  • Health Informatics
  • Biostatistics

Background:

  • Accurate coding is crucial for claim-based studies.
  • Evaluating coding accuracy for specific conditions like fifth metatarsal fracture nonunion is challenging without direct chart review.

Purpose of the Study:

  • To present a method for assessing the accuracy of administrative claims coding for nonunion of a fifth metatarsal fracture.
  • To determine the reliability of using subsequent health care encounters and treatments as indicators of confirmed nonunion diagnosis.

Main Methods:

  • Retrospective analysis of administrative claims data (MarketScan Databases) from 2016.
  • Identification of patients aged 21-80 with fifth metatarsal fracture and subsequent nonunion diagnosis.
  • Examination of health care claims within 12 months post-nonunion diagnosis for confirmatory evidence.

Main Results:

  • Of 230 patients with a nonunion diagnosis, 95.2% had at least one subsequent confirmatory health care encounter.
  • The mean number of supporting health care claims was 5.8.
  • The mean time between nonunion diagnosis and the first confirmatory claim was 33 days.

Conclusions:

  • The study demonstrates a feasible method for evaluating coding quality for nonunion of fifth metatarsal fracture using real-world data.
  • Administrative claims data can reliably confirm nonunion diagnoses when direct chart review is not possible.