|Title:||Administrative data on diagnosis and mineralocorticoid receptor antagonist prescription identified patients with primary aldosteronism in Taiwan||Authors:||Hu Y.-H.
|Issue Date:||2014||Publisher:||Elsevier USA||Journal Volume:||67||Journal Issue:||10||Start page/Pages:||1139-1149||Source:||Journal of Clinical Epidemiology||Abstract:||
Objectives To develop algorithms of locating patients with primary aldosteronism (PA) using insurance reimbursement data and to validate the algorithms using medical charts.Study Design and Setting We extracted National Health Insurance (NHI) reimbursement data and medical charts in seven enrolled hospitals and analyzed diagnosis-related information for 1999-2010. The NHI codes PA as 255.1x, using the International Classification of Diseases, Ninth Revision, Clinical Modification. Confirmation of PA was based on suppression tests.Results We reviewed medical charts for 1,094 cases with at least one PA diagnosis. PA was confirmed for 563 cases. Compared with patients with essential hypertension, PA patients had higher systolic blood pressure, higher aldosterone, lower renin activity, and lower potassium level (all P-values <0.05). An algorithm based on PA diagnosis reported in at least one hospital stay or three outpatient visits had modest performance (sensitivity = 0.94 and specificity = 0.20). The best additional condition for the algorithm was use of mineralocorticoid receptor antagonist (MRA; sensitivity = 0.89 and specificity = 0.88).Conclusion Using information on PA diagnosis and MRA prescription reported in insurance claims data can precisely locate PA patients in high-risk groups. This algorithm can construct a reliable PA sample for conducting research in various fields, including epidemiology and clinical practice. ? 2014 Elsevier Inc.
|ISSN:||0895-4356||DOI:||10.1016/j.jclinepi.2014.05.012||metadata.dc.subject.other:||aldosterone; mineralocorticoid antagonist; potassium; prescription drug; renin; mineralocorticoid antagonist; adult; Article; controlled study; data extraction; diagnostic accuracy; diagnostic test accuracy study; essential hypertension; feasibility study; female; high risk patient; hospital patient; human; ICD-9-CM; length of stay; major clinical study; male; medical record review; national health insurance; outpatient care; patient identification; prescription; primary hyperaldosteronism; reimbursement; sensitivity and specificity; systolic blood pressure; Taiwan; aged; algorithm; hyperaldosteronism; medical record; middle aged; prescription; reproducibility; statistics and numerical data; Adult; Aged; Algorithms; Drug Prescriptions; Female; Humans; Hyperaldosteronism; Insurance, Health, Reimbursement; Male; Medical Records; Middle Aged; Mineralocorticoid Receptor Antagonists; Reproducibility of Results; Taiwan
|Appears in Collections:||醫學系|
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