Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Konstantelos, Natalia, Burden, Andrea M., Cheung, Angela M., Kim, Sandra, Grootendorst, Paul, Cadarette, Suzanne M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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
_version_ 1784911913892708352
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
work_keys_str_mv AT konstantelosnatalia comparisonoffractureidentificationusingdifferentdefinitionsinhealthcareadministrativeclaimsdata
AT burdenandream comparisonoffractureidentificationusingdifferentdefinitionsinhealthcareadministrativeclaimsdata
AT cheungangelam comparisonoffractureidentificationusingdifferentdefinitionsinhealthcareadministrativeclaimsdata
AT kimsandra comparisonoffractureidentificationusingdifferentdefinitionsinhealthcareadministrativeclaimsdata
AT grootendorstpaul comparisonoffractureidentificationusingdifferentdefinitionsinhealthcareadministrativeclaimsdata
AT cadarettesuzannem comparisonoffractureidentificationusingdifferentdefinitionsinhealthcareadministrativeclaimsdata