Title | Misclassification of incident hospitalized and outpatient heart failure in administrative claims data: the Atherosclerosis Risk in Communities (ARIC) study. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Camplain R, Kucharska-Newton AMaria, Cuthbertson CC, Wright JD, Alonso A |
Secondary Authors | Heiss G |
Journal | Pharmacoepidemiol Drug Saf |
Volume | 26 |
Issue | 4 |
Pagination | 421-428 |
Date Published | 2017 Apr |
ISSN | 1099-1557 |
Keywords | Aged, Algorithms, Cohort Studies, Databases, Factual, Female, Heart Failure, Hospitalization, Humans, Incidence, International Classification of Diseases, Male, Medicare, Outpatients, Prospective Studies, Sample Size, Time Factors, United States |
Abstract | PURPOSE: The aim of this study was to quantify the influence of the length of the look-back period on misclassification of heart failure (HF) incidence in Medicare claims available for participants of a population-based cohort. METHODS: Atherosclerosis Risk in Communities participants with ≥3 years of continuous fee-for-service Medicare enrollment from 2000 to 2012 was assigned an index date 36 months after enrollment separating the time-in-observation period into the look-back and the incidence periods. Incident HF events were identified using ICD-9-CM code algorithms as the first observed hospitalization claim or the second of two HF outpatient claims occurring within 12 months. Using 36 months as a referent, the look-back period was reduced by 6-month increments. For each look-back period, we calculated the incidence rate, percent of prevalent HF events misclassified as incident, and loss in sample size. RESULTS: We identified 9568 Atherosclerosis Risk in Communities participants at risk for HF. For hospitalized and outpatient HF, the number of events misclassified as incident increased, and the total number of incident events decreased with increased length of the look-back period. The incident rate (per 1000 person years) decreased with increased length of the look-back period from 6 to 36 months and had a greater impact on outpatient HF; for example, from 11.2 to 10.6 for ICD-9-CM 428.xx hospitalization in the primary position and 10.5 to 7.9 for outpatient HF. CONCLUSION: Our estimates can be used to optimize trade-offs between the degree of misclassification and number of events in the estimation of incident HF from administrative claims data, as pertinent to different study questions. Copyright © 2017 John Wiley & Sons, Ltd. |
DOI | 10.1002/pds.4162 |
Alternate Journal | Pharmacoepidemiol Drug Saf |
PubMed ID | 28120359 |
PubMed Central ID | PMC5380482 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100009I / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100011I / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States U01 HL075572 / HL / NHLBI NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States HHSN268201100005I / HL / NHLBI NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States HHSN268201100007I / HL / NHLBI NIH HHS / United States T32 HL007055 / HL / NHLBI NIH HHS / United States |