Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, MA, USA.
Pharmacoepidemiol Drug Saf. 2011 Nov;20(11):1168-76. doi: 10.1002/pds.2217. Epub 2011 Aug 22.
To evaluate the validity of health plan administrative and claims data to identify pre-gestational and gestational diabetes, obesity, and ultrasounds among pregnant women.
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.
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%).
Health plan administrative and claims data can be used to accurately identify pre-gestational and gestational diabetes and ultrasounds. Obesity is not consistently coded.
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。
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。
总体而言，222 例糖尿病病例中有 190 例（86%）得到了确认（82%为妊娠期糖尿病，74%为孕前糖尿病）。超声检查代码的阳性预测值为 80%。而肥胖相关诊断代码的阳性预测值很高（93%），但敏感性较低（33%）。
健康计划管理和理赔数据可用于准确识别孕前和妊娠期糖尿病以及超声检查。肥胖症的编码并不一致。
