Dow Division of Health Services Research, Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.
Litholink Corporation, Laboratory Corporation of America Holdings, Itasca, Illinois.
Urol Pract. 2023 Mar;10(2):147-152. doi: 10.1097/UPJ.0000000000000378. Epub 2023 Jan 25.
To overcome the data availability hurdle of observational studies on urolithiasis, we linked claims data with 24-hour urine results from a large cohort of adults with urolithiasis. This database contains the sample size, clinical granularity, and long-term follow-up needed to study urolithiasis on a broad level.
We identified adults enrolled in Medicare with urolithiasis who had a 24-hour urine collection processed by Litholink (2011 to 2016). We created a linkage of their collections results and paid Medicare claims. We characterized them across a variety of sociodemographic and clinical factors. We measured frequencies of prescription fills for medications used to prevent stone recurrence, as well as frequencies of symptomatic stone events, among these patients.
In total, there were 11,460 patients who performed 18,922 urine collections in the Medicare-Litholink cohort. The majority were male (57%), White (93.2%), and lived in a metropolitan county (51.5%). Results from their initial urine collections revealed abnormal pH to be the most common abnormality (77.2%), followed by low volume (63.8%), hypocitraturia (45.6%), hyperoxaluria (31.1%), hypercalciuria (28.4%), and hyperuricosuria (11.8%). Seventeen percent had prescription fills for alkali monotherapy, and 7.6% had prescription fills for thiazide diuretic monotherapy. Symptomatic stone events occurred in 23.1% at 2 years of follow-up.
We successfully linked Medicare claims with results from 24-hour urine collections performed by adults that were processed by Litholink. The resulting database is a unique resource for future studies on the clinical effectiveness of stone prevention strategies and urolithiasis more broadly.
为了克服观察性尿路结石研究中数据可用性的障碍，我们将索赔数据与来自大型尿路结石患者队列的 24 小时尿液结果相链接。该数据库包含了研究尿路结石的广泛层面所需的样本量、临床粒度和长期随访。
我们确定了 Medicare 中患有尿路结石且接受 Litholink 处理的 24 小时尿液收集的成年人。我们创建了他们收集结果和支付 Medicare 索赔的链接。我们根据各种社会人口统计学和临床因素对他们进行了描述。我们测量了这些患者预防结石复发的药物处方频率，以及症状性结石事件的频率。
在 Medicare-Litholink 队列中，共有 11460 名患者进行了 18922 次尿液收集。大多数患者为男性（57%）、白人（93.2%），居住在大都市区（51.5%）。他们的初始尿液收集结果显示，异常 pH 值是最常见的异常（77.2%），其次是低容量（63.8%）、低柠檬酸尿症（45.6%）、高草酸尿症（31.1%）、高钙尿症（28.4%）和高尿酸尿症（11.8%）。17%的患者有碱单一疗法的处方，7.6%的患者有噻嗪类利尿剂单一疗法的处方。在 2 年的随访中，有 23.1%的患者出现症状性结石事件。
我们成功地将 Medicare 索赔与 Litholink 处理的成年人 24 小时尿液收集结果相链接。由此产生的数据库是未来研究结石预防策略和更广泛的尿路结石的独特资源。
