Validation of a claims-based diagnostic code for Stevens-Johnson syndrome in a commercially insured population.

نویسندگان

  • Debra F Eisenberg
  • Gregory W Daniel
  • Judith K Jones
  • Earl L Goehring
  • Peter M Wahl
  • Peter Winters
  • Jay Levin
  • Rhonda L Bohn
چکیده

PURPOSE: To validate the administrative claims identification of a diagnosis of Stevens-Johnson syndrome (SJS) using medical records as the "gold standard" in a large, commercially insured US population. METHODS: Patients with >1 medical claim with the International Classification of Diseases, Ninth Revision, Clinical Modification code 695.1x between 1 July 2000 and 31 May 2007 were queried in the HealthCore Integrated Research Database(SM) , which contains administrative claims data for 14 commercial health insurance plans. Trained nurses and pharmacists abstracted pertinent information from the identified patients' medical records, which were then reviewed by two independent dermatologists to identify criteria to determine SJS diagnosis. Positive predictive values (PPVs) based on the claims and chart data were computed for all the cases. RESULTS: Medical charts for 200 claims-identified cases, with the International Classification of Diseases, Ninth Revision, Clinical Modification code 695.1x, were abstracted and reviewed by the dermatologists. A total of five cases (PPV = 2.50%, 95%CI = 0.8%-5.7%) were determined to be SJS with clinical certainty. PPVs varied with data stratification: PPV for inpatient claims only (PPV = 2.00%, 95%CI = 0.24%-7.04%), inpatient claims with 695.1x in first diagnosis field (PPV = 4.11%, 95%CI = 0.86%-11.54%), and final decisions of either clinical certainty or probable cases of SJS (PPV = 6.00%, 95%CI = 3.14%-10.25%). CONCLUSION: These findings demonstrate the difficulties associated with identifying rare disorders, which lack specific diagnostic criteria, within administrative claims databases. They underscore the challenges of using claims data to monitor ill-defined clinical conditions as well as the need to validate claims-identified cases with information from other sources, such as medical charts. Copyright © 2012 John Wiley & Sons, Ltd.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Idiopathic Stevens-Johnson Syndrome in a Child: a Case Report

Background Stevens-Johnson syndrome (SJS) is one of potentially fatal disorders that often occur after taking certain types of medication. There are reports of this disease after some infections. This paper presents the case of a young boy with idiopathic Stevens-Johnson syndrome. Case Report A six-year-old male patient with complaint of fever and skin lesions was transferred to emergency depar...

متن کامل

Administration of Intravenous Immunoglobulin in the Management of Two Different Cases of Stevens-Johnson Syndrome

Two different cases of Stevens - Johnson syndrome are reported. We used intravenous immunoglobulin in their management and compared the results of treatment with the conventional lines of therapy in a historical control.

متن کامل

Comparison of Complications and length of Hospitalization in management of Stevens-Johnson Syndrome with Systemic Steroid or Supportive Care

ABSTRACT Stevens-Johnson syndrome (SJS) is a serious acute self limited emergency in dermatology with considerable morbidity and mortality, Its specific therapy with systemic steroids has been the matter of challenge and controversy in the past 4 decades. The purpose of this study was comparing of complications and the length of hospitalization between those treated with steroids and supporti...

متن کامل

Diclofenac-Induced Stevens-Johnson Syndrome: A Case Report

Drugs are an important cause of Stevens–Johnson syndrome(SJS) in about 95% of reports. 100 drugs have been reported as causes of SJS or toxic epidermal necrolysis (TEN). There are very few reports of SJS due to use of diclofenac. In this report we present a 65 year old lady who developed SJS after usage of diclofenac suppository.

متن کامل

Reactivation of Cytomegalovirus in a Patient with Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions to drugs. We describe the case of a 19 year old patient with SJS/TEN overlap syndrome, who developed severe interstitial pneumonia after she had received antiepileptic drugs. A cytomegalovirus infection was diagnosed by Real Time Polymerase Chain Reaction (RT-PCR) detection on Bronchoalveo...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Pharmacoepidemiology and drug safety

دوره 21 7  شماره 

صفحات  -

تاریخ انتشار 2012