基于诊断编码的RSV发病率的模型校正,针对美国0-4岁儿童
Sabina O Nduaguba1,2,3, Phuong T Tran3,4, Almut G Winterstein5,6,7
1Department of Pharmaceutical Systems and Policy, College of Pharmacy, West Virginia University, Morgantown, WV, USA.
BMC infectious diseases
|June 21, 2024
概括
行政索赔数据低估了呼吸道共囊病毒 (RSV) 下呼吸道感染 (RSV-LRTI). 使用RSV监测调整索赔数据可以提高准确性,但在特定数据无法获得时,建议跨设置建模.
科学领域:
- 流行病学 流行病学
- 公共卫生监督 公共卫生监督
- 医疗信息学 医疗信息学
背景情况:
- 行政索赔数据具有高度的完整性,但对于医疗护理的呼吸道同胞病毒相关的下呼吸道感染 (RSV-LRTI) 的致病原体通常是不明确的.
- 在索赔数据中,准确地将RSV归因于LRTI对于了解疾病负担至关重要.
研究的目的:
- 通过对监测数据对LRTI率的时间变化进行建模来确定索赔数据中RSV与LRTI的归因.
- 在行政索赔中评估RSV-LRTI编码的准确性.
主要方法:
- 0-4岁儿童每周LRTI发生率估计来自2011-2019年商业保险索赔,按HHS地区分层.
- 模型与每周NREVSSRSV和流感阳性数据相匹配,结合RSV和流感阳性率和时间函数,使用负二项分布.
- 归因于RSV的LRTI事件是通过从完整模型预测中减去零RSV阳性预测事件来计算的.
主要成果:
- 大约42%的预测RSV病例在索赔数据中被编码.
- 归因于RSV的LRTI的百分比因地区而异:15-43% (住院患者),10-31% (门诊患者) 和10-31% (组合患者).
- 在10个地区中,有9个地区在与编码的住院RSV-LRTI相比显示不太可能的修正住院LRTI估计值,这表明低估值.
结论:
- 在索赔数据中低估RSV-LRTI可以通过调整基于索赔的RSV发病率,使用NREVSS监测数据来减轻.
- 当特定设置的阳性率无法获得时,建议在所有设置中建模,以与聚合的NREVSS阳性率保持一致,并防止不准确的调整.
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