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Evaluation of a Methodological Approach to Define An Inception Cohort of Rheumatoid Arthritis Patients Using Administrative Data

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Curtis JR1,2, Xie F1, Chen L1, Greenberg JD3, Zhang J2. Arthritis Care Res (Hoboken). 2018 Feb 6. doi: 10.1002/acr.23533. [Epub ahead of print]


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1 Division of Clinical Immunology and Rheumatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.

2 Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.

3 Corrona, LLC, Southborough, MA; 4. New York University School of Medicine, New York, NY.


BACKGROUND/PURPOSE: Identifying incident rheumatoid arthritis (RA) is desirable to create inception cohorts. We evaluated an approach to identify incident RA in health plan claims data.

METHODS: Both Medicare and commercial claims data was linked to Corrona, a U.S. RA registry. We evaluated accuracy of year of RA onset in the registry (gold standard) versus different claims algorithms, varying ICD-9 codes for RA/arthritis, duration of health plan enrollment preceding diagnosis (minimum of 1 vs. 2 years) and use of RA medications. Results were reported as positive predictive values (PPVs) of the claims-based algorithm for incident RA.

RESULTS: Depending on algorithm tested and whether patients were enrolled in Medicare or the commercial health plan, the PPVs for incident RA ranged from 68%-81%. A 2 year clean period free of all RA-related diagnoses and RA medications was somewhat more optimal, although by comparison, a 1 year clean period yielded similar PPVs and retained approximately 90% more RA patients for analysis.

CONCLUSION: Claims-based algorithms can accurately identify incident RA.