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Validation of an Algorithm to Identify Venous Thromboembolism in Health Insurance Claims Data Among Patients with
Sangmi Kim1, Carolyn Martin2, John White2
1Global Patient Safety Pharmacoepidemiology, Eli Lilly and Company, Indianapolis, IN, USA.
Clinical Epidemiology
|June 7, 2023
Summary
Health insurance claims data can identify venous thromboembolism (VTE) in rheumatoid arthritis (RA) patients. A primary algorithm showed a 75.5% positive predictive value for VTE detection in RA cases.
Area of Science:
- Medical informatics
- Rheumatology
- Epidemiology
Background:
- Venous thromboembolism (VTE) is a significant concern in patients with rheumatoid arthritis (RA).
- Health insurance claims databases offer a valuable resource for studying VTE in large RA populations.
- Accurate identification of VTE in claims data is crucial for epidemiological research.
Purpose of the Study:
- To evaluate case definitions for identifying VTE among patients treated for RA using ICD-10-CM codes in claims data.
- To assess the performance of primary and secondary algorithms for VTE detection.
- To explore the utility of a linked EHR claims database for validating VTE outcome definitions.
Main Methods:
- Retrospective study of insured adults with RA (2016-2020).
- VTE identification using predefined algorithms based on ICD-10-CM codes, anticoagulant use, and care setting.
- Medical chart abstraction for VTE diagnosis confirmation and calculation of positive predictive value (PPV).
- Validation using a linked electronic health record (EHR) claims database.
Main Results:
- The primary VTE algorithm achieved a PPV of 75.5% (117/155).
- A secondary, less stringent algorithm had a PPV of 52.6% (40/76).
- PPV was lower when using an alternative EHR-linked claims database, possibly due to data limitations.
Conclusions:
- Administrative claims data are a feasible tool for identifying VTE in RA patients for observational studies.
- The developed algorithms provide a basis for future research on VTE in RA populations using claims data.
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