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Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data
We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults trea...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037590/ https://www.ncbi.nlm.nih.gov/pubmed/36961031 http://dx.doi.org/10.3390/pharmacy11020053 |
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author | Konstantelos, Natalia Burden, Andrea M. Cheung, Angela M. Kim, Sandra Grootendorst, Paul Cadarette, Suzanne M. |
author_facet | Konstantelos, Natalia Burden, Andrea M. Cheung, Angela M. Kim, Sandra Grootendorst, Paul Cadarette, Suzanne M. |
author_sort | Konstantelos, Natalia |
collection | PubMed |
description | We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for ≥3 years. The most inclusive definition (hip: inpatient or emergency diagnosis; radius/ulna: inpatient, emergency, or outpatient diagnosis) served as a referent to compare the number and proportion of fractures captured. In sensitivity analyses, we considered a 180-day washout, excluded fractures associated with trauma; and hip only, excluded: (1) subtrochanteric fractures, and (2) hip replacement procedures. Hip fractures varied by definition in number (52–8058) and incidence (0.7–111.8/10,000 person-years). The second most inclusive definition required one inpatient diagnosis and identified 8% fewer hip fractures than the referent. Excluding hip replacements missed 33% of hip fractures relative to the primary analysis. Radius/ulna fractures also ranged in number (1589–6797) and incidence (22.0–94.3/10,000 person-years). Outpatient data were important, when restricted to inpatient or emergency data, only 78% of radius/ulna fractures were identified. Other than hip replacement procedures, sensitivity analyses had minimal impact on fracture identification. Analyses were replicated in a cohort of patients treated with long-term glucocorticoids. This study highlights the importance and impact of coding decisions on fracture outcome definitions. Further research is warranted to inform best practice in fracture outcome identification. |
format | Online Article Text |
id | pubmed-10037590 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100375902023-03-25 Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data Konstantelos, Natalia Burden, Andrea M. Cheung, Angela M. Kim, Sandra Grootendorst, Paul Cadarette, Suzanne M. Pharmacy (Basel) Article We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for ≥3 years. The most inclusive definition (hip: inpatient or emergency diagnosis; radius/ulna: inpatient, emergency, or outpatient diagnosis) served as a referent to compare the number and proportion of fractures captured. In sensitivity analyses, we considered a 180-day washout, excluded fractures associated with trauma; and hip only, excluded: (1) subtrochanteric fractures, and (2) hip replacement procedures. Hip fractures varied by definition in number (52–8058) and incidence (0.7–111.8/10,000 person-years). The second most inclusive definition required one inpatient diagnosis and identified 8% fewer hip fractures than the referent. Excluding hip replacements missed 33% of hip fractures relative to the primary analysis. Radius/ulna fractures also ranged in number (1589–6797) and incidence (22.0–94.3/10,000 person-years). Outpatient data were important, when restricted to inpatient or emergency data, only 78% of radius/ulna fractures were identified. Other than hip replacement procedures, sensitivity analyses had minimal impact on fracture identification. Analyses were replicated in a cohort of patients treated with long-term glucocorticoids. This study highlights the importance and impact of coding decisions on fracture outcome definitions. Further research is warranted to inform best practice in fracture outcome identification. MDPI 2023-03-14 /pmc/articles/PMC10037590/ /pubmed/36961031 http://dx.doi.org/10.3390/pharmacy11020053 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Konstantelos, Natalia Burden, Andrea M. Cheung, Angela M. Kim, Sandra Grootendorst, Paul Cadarette, Suzanne M. Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data |
title | Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data |
title_full | Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data |
title_fullStr | Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data |
title_full_unstemmed | Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data |
title_short | Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data |
title_sort | comparison of fracture identification using different definitions in healthcare administrative (claims) data |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037590/ https://www.ncbi.nlm.nih.gov/pubmed/36961031 http://dx.doi.org/10.3390/pharmacy11020053 |
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