验证用于确定妊娠期间临床情况和医疗程序的算法。

Validation of algorithms to ascertain clinical conditions and medical procedures used during pregnancy.

机构信息

Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, MA, USA.

出版信息

Pharmacoepidemiol Drug Saf. 2011 Nov;20(11):1168-76. doi: 10.1002/pds.2217. Epub 2011 Aug 22.

DOI:10.1002/pds.2217

PMID:22020902

Abstract

PURPOSE

To evaluate the validity of health plan administrative and claims data to identify pre-gestational and gestational diabetes, obesity, and ultrasounds among pregnant women.

METHODS

A retrospective study was conducted using the administrative and claims data of three health plans participating in the HMO Research Network. Diagnoses, drug dispensings, and procedure codes were used to identify diabetes, obesity, and ultrasounds among women who were pregnant between January 2006 and December 2008. A random sample of medical charts (n = 222) were abstracted. Positive predictive values (PPVs) were calculated. Sensitivity also was calculated for obesity among women for whom body mass index data were available in electronic medical records at two sites.

RESULTS

Overall, 190 of 222 cases of diabetes (86%) were confirmed (82% for gestational diabetes and 74% for pre-gestational diabetes). The PPV for codes to identify ultrasounds was 80%. Whereas the PPV for obesity-related diagnosis codes was high (93%), and the sensitivity was low (33%).

CONCLUSIONS

Health plan administrative and claims data can be used to accurately identify pre-gestational and gestational diabetes and ultrasounds. Obesity is not consistently coded.

摘要

目的

评估健康计划管理和理赔数据在识别孕妇的孕前和妊娠期糖尿病、肥胖症和超声检查方面的有效性。

方法

本研究采用参与 HMO 研究网络的三个健康计划的管理和理赔数据进行回顾性研究。在 2006 年 1 月至 2008 年 12 月期间，使用诊断、药物配给和程序代码来识别糖尿病、肥胖症和超声检查。对随机抽取的 222 份医疗记录（n=222）进行了摘录。计算了阳性预测值（PPV）。对于两个地点电子病历中有体重指数数据的肥胖女性，还计算了肥胖症的敏感度。