Patients diagnosed with irritable bowel syndrome: medical record validation of a claims-based identification algorithm.

Objective: This study developed and validated a claims-based algorithm for identifying patients with irritable bowel syndrome (IBS) and investigated the characteristics of patients associated with a correct identification.Methods: Using a classification tree procedure, a claims-based algorithm was d...

Full description

Bibliographic Details
Published in:Disease Management & Health Outcomes Vol. 10; no. 11; pp. 715 - 723
Main Authors: Legorreta AP, Ricci J, Markowitz M, Jhingran P
Format: research tables/charts Journal Article
Published: Springer Nature Nov2002
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106817678&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 106817678
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        11738790
        C4Y
      jtl: Disease Management & Health Outcomes
      issn: 11738790
      maglogo: N
    pubinfo:
      dt: Nov2002
      vid: 10
      iid: 11
      pid: 87227
      pub: Springer Nature
    artinfo:
      ui:
        106817678
        2003046241
        10.2165/00115677-200210110-00005
        106817678
      ppf: 715
      ppct: 8
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Patients diagnosed with irritable bowel syndrome: medical record validation of a claims-based identification algorithm.
      aug:
        au:
          Legorreta AP
          Ricci J
          Markowitz M
          Jhingran P
        affil: Adjunct Associate Professor, Department of Health Services, UCLA School of Public Health, Los Angeles, California; alegorreta@healthbenchmarks.com
      sug:
        subj:
          Irritable Bowel Syndrome
          Coding
          Billing and Claims
          Current Procedural Terminology
          International Classification of Diseases
          Descriptive Statistics
          Chi Square Test
          Data Analysis, Statistical
          Data Analysis Software
          Record Review
          Regression
          Adult
          Middle Age
          Male
          Female
          Funding Source
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objective: This study developed and validated a claims-based algorithm for identifying patients with irritable bowel syndrome (IBS) and investigated the characteristics of patients associated with a correct identification.Methods: Using a classification tree procedure, a claims-based algorithm was developed and tested against medical chart findings. Patients' medical charts were reviewed to verify diagnoses. The classification tree separated the patient population into 12 mutually exclusive subgroups and had an overall positive predictive value (PPV) of 70%.Setting and Participants: Claims data were obtained for adults aged 18 years or older who were enrolled in a large health maintenance organization in California, USA, during the study period (January 1 1997 to June 30 1999) and who had at least one claim with a primary International Classification of Diseases Ninth Revision Clinical Modification (ICD-9-CM) diagnosis of 564.1 (irritable colon) in 1998. In October 2000 this code description was revised to 'irritable bowel syndrome'.Results: The PPVs of end nodes of the tree varied (18 to 100%) depending on the demographic, type of resource utilized, and diagnoses characterizing the 12 groups. Younger patients (aged <50 years) and those with several claims with a 564.1 ICD-9-CM code were more likely to be patients with IBS. The PPV for each of these 12 subgroups could be used as a covariate in regression models that predict outcomes of IBS and its management.Conclusions: Claims databases provide an efficient and effective tool for conducting health services research on large patient populations. Medical record validation of claims-based algorithms is an important step in improving the reliability and utility of these databases.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N