Algorithms to identify colonic ischemia, complications of constipation and irritable bowel syndrome in medical claims data: Development and validation

Bruce E. Sands, Mei Sheung Duh, Clorinda Cali, Anuli Ajene, Rhonda L. Bohn, David Miller, J. Alexander Cole, Suzanne F. Cook, Alexander M. Walker

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Purpose: A challenge in the use of insurance claims databases for epidemiologic research is accurate identification and verification of medical conditions. This report describes the development and validation of claims-based algorithms to identify colonic ischemia, hospitalized complications of constipation, and irritable bowel syndrome (IBS). Methods: From the research claims databases of a large healthcare company, we selected at random 120 potential cases of IBS and 59 potential cases each of colonic ischemia and hospitalized complications of constipation. We sought the written medical records and were able to abstract 107, 57, and 51 records, respectively. We established a 'true' case status for each subject by applying standard clinical criteria to the available chart data. Comparing the insurance claims histories to the assigned case status, we iteratively developed, tested, and refined claims-based algorithms that would capture the diagnoses obtained from the medical records. We set goals of high specificity for colonic ischemia and hospitalized complications of constipation, and high sensitivity for IBS. Results: The resulting algorithms substantially improved on the accuracy achievable from a naïve acceptance of the diagnostic codes attached to insurance claims. The specificities for colonic ischemia and serious complications of constipation were 87.2 and 92.7%, respectively, and the sensitivity for IBS was 98.9%. Conclusions: U.S. commercial insurance claims data appear to be usable for the study of colonic ischemia, IBS, and serious complications of constipation.

Original languageEnglish
Pages (from-to)47-56
Number of pages10
JournalPharmacoepidemiology and Drug Safety
Volume15
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Keywords

  • Automated databases
  • Colonic ischemia
  • Constipation
  • Epidemiology
  • Irritable bowel syndrome

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