PCN245 USE OF MEDICAL CLAIMS DATA TO ASSESS THE IMPACT OF GENOMIC CLASSIFIERS ON UNDERDIAGNOSIS OF MALIGNANCIES OF THE THYROID GLAND VERSUS PERFORMING UNNECESSARY SURGERIES

Abstract Sensory impairment is prevalent among older adults and may increase risk for delirium via mechanisms including sensory deprivation and poor communication which may result in confusion and agitation. In the Medicare Current Beneficiary Study (MCBS), delirium was measured using a validated algorithm of claims data. Sensory impairment was defined as any self-reported trouble hearing or seeing, with the use of aids, and was categorized as no impairment, hearing impairment only (HI), vision impairment only (VI), and dual sensory impairment (DSI). Among, 3,240 hospitalized participants in 2016-2017, 346 (10.7%) experienced delirium. In a model adjusted for socio-demographic and health characteristics, those with HI only, VI only, and DSI had 0.84 (95% CI: 0.6-1.3), 1.1 (95% CI 0.7-1.7), and 1.5 (95% CI 1.0-2.1) times the odds of experiencing delirium compared to those without sensory impairment. Future research should focus on mechanisms underlying association and determine the impact of treatment of sensory loss.

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Abstract 223: Impact of Differences in Once- vs Twice-Daily Medications Adherence on the Risk of Bleed and Stroke in Non-Valvular Atrial Fibrillation: Analysis of Randomized Trials and Claims Data Sources

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.223 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Colleen A McHorney ◽

Eric D Peterson ◽

Mike Durkin ◽

Veronica Ashton ◽

François Laliberté ◽

...

Keyword(s):

Atrial Fibrillation ◽

Stroke Risk ◽

Claims Data ◽

Meta Analysis ◽

Oral Anticoagulants ◽

Once Daily ◽

Cardiovascular Medications ◽

One Year ◽

The Impact ◽

Similar Risk

Background: In non-valvular atrial fibrillation (NVAF) patients, those receiving once-daily (QD) versus twice-daily (BID) non vitamin-K antagonist oral anticoagulants (NOACs) may have better medication adherence. The impact on stroke and bleed risk is not known. Objective: To estimate the impact of adherence differences between QD vs BID therapies on bleed and stroke risks in NVAF patients. Methods: The relation between adherence (proportion of days covered [PDC]) for QD vs BID NOACs and one year bleed risk was modeled using claims data from Truven Health Analytics MarketScan databases (7/2012-10/2015). Next, the relation between adherence and bleeding was calibrated to match that seen in the placebo and NOAC arms of previous randomized controlled trials (RCTs). Finally, we used adherence rates for QD (PDC=0.849) and BID (PDC=0.738) cardiovascular medications from a meta-analysis (Coleman et al.). These rates were used in the calibrated model to estimate bleeds. An analogous method was applied to evaluate the impact of QD vs BID adherence on stroke risk. Results: The relation between PDC and risks of bleed and stroke was modeled using claims data (N=65,022) and calibrated using RCTs. In the calibrated model, compared with BID dosing, QD dosing was associated with 81 fewer strokes (34% reduction) and 14 more bleeds (6% more) per 10,000 patients/year (Figure). Conclusion: Among NVAF patients, better adherence to QD dosing was associated with a significantly lower stroke risk of QD but similar risk of bleed.

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Abstract 18020: Identifying Hospitalizations Related to Heart Failure in Dronedarone Users Who Are Supplementary Medicare Beneficiaries

Circulation ◽

10.1161/circ.130.suppl_2.18020 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Chuntao Wu ◽

Andrew Koren ◽

Jane Thammakhoune ◽

Jasmanda Wu ◽

Hayet Kechemir ◽

...

Keyword(s):

Heart Failure ◽

Confidence Interval ◽

Claims Data ◽

Search Algorithm ◽

Medicare Beneficiaries ◽

Current Procedural Terminology ◽

Diagnosis Codes ◽

Medicare Database ◽

The Impact

Background: When using inpatient claims data to identify hospitalizations in supplemental Medicare beneficiaries, e.g., in the MarketScan database, there is a concern that the coverage of hospitalizations in such inpatient claims may be incomplete. However, whether hospitalizations are covered by inpatient claims or not, they incur professional charges that are recorded in the professional claims data in the MarketScan Medicare database. In the context of identifying hospitalizations that might be related to heart failure (HF) in dronedarone users, we compared different approaches to identify such hospitalizations. Objective: To assess the impact of using professional claims in addition to inpatient claims on identifying hospitalizations that might be related to HF. Methods: A total of 20,834 dronedarone users who were supplemental Medicare beneficiaries between July 2009 (launch date in US) and December 2012 were identified in the MarketScan database. The hospitalizations that might be related to HF within 30 days prior to initiating dronedarone were identified by searching (1) inpatient claims and (2) both inpatient and professional claims using related ICD-9-CM diagnosis codes for HF and Current Procedural Terminology codes for hospitalizations. Results: A total of 1,162 patients who had HF hospitalizations within 30 days prior to initiating dronedarone were identified by searching inpatient claims between July 2009 and December 2012. Supplementing with professional claims identified an additional 177 patients who had HF hospitalizations, increasing the total number to 1,339. Therefore, 13.2% (177/1,399) of the patients who had HF hospitalizations could only be identified in professional claims. Thus, the prevalence of hospitalizations that might be related to HF within 30 days prior to initiating dronedarone was 5.6% (1,162/20,834; 95% confidence interval (CI): 5.3 - 5.9%) when hospitalizations were identified using inpatient claims alone. Adding professional claims in the search algorithm, the prevalence of HF hospitalizations was 6.4% (1,339/20,834, 95% CI: 6.1 - 6.8%). Conclusions: Using professional claims, in addition to inpatient claims, can improve the identification of hospitalizations that might be related to HF.

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Bisphosphonates Are Associated With Increased Risk for Jaw Surgery in Medical Claims Data: Is it Osteonecrosis?

Yearbook of Dermatology and Dermatologic Surgery ◽

10.1016/s0093-3619(08)70543-4 ◽

2007 ◽

Vol 2007 ◽

pp. 255-256

Author(s):

B.H. Thiers

Keyword(s):

Claims Data ◽

Medical Claims ◽

Increased Risk ◽

Jaw Surgery

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Thyroid Disorders and COVID-19

Doctor Ru ◽

10.31550/1727-2378-2021-20-2-6-10 ◽

2021 ◽

Vol 20 (2) ◽

pp. 6-10

Author(s):

N.A. Petunina ◽

◽

Ya.A. Al Taravi ◽

A.Yu. Surkova ◽

N.S. Martirosyan ◽

...

Keyword(s):

Thyroid Gland ◽

Pulmonary Complications ◽

Target Cells ◽

Thyroid Disorders ◽

Autoimmune Thyroid ◽

Direct Invasion ◽

Global Pandemic ◽

Novel Coronavirus ◽

Available Information ◽

The Impact

Objective of the Review: To present the available information on the SARS-CoV-2 impact on thyroid gland (TG), impact from a thyroid pathology over COVID-19 morbidity and course, and management of patients with various thyroid pathologies and the novel coronavirus infection. Key Points. SARS-CoV-2 virus demonstrates exponential spread all over the globe and has caused a global pandemic of COVID-19 infection. Currently, the mechanism of non-pulmonary complications of SARS-CoV-2 and endocrine involvement is yet not clear. The impact from SARS-CoV-2 on TG can be a result of direct invasion of target cells by the virus or activation of immunise and inflammatory response.Changes in the pituitary-hypothalamic thyroid system can be caused by developing euthyroid pathology syndrome, glucocorticosteroid therapy, destructive thyroiditis. Manifestation of autoimmune thyroid disorders associated with COVID-19 cannot be ruled out. Conclusion. Currently there is no information on direct thyroid invasion by SARS-CoV-2; however the available results from trials and clinical observations demonstrate possible impact from coronavirus infections, in particular from SARS-CoV and SARS-CoV-2, on the pituitaryhypothalamic-thyroid system with development of various pathologies or a number of changes in thyroid hormone levels. Taking into account possible associations between thyroid dysfunction and prolonged hospitalisation, risk of deaths in hospital, and the association between thyrotoxicosis and atrial fibrillation and hypercoagulation, it is advisable to screen patients with severe COVID-19. Keywords: SARS-CoV-2, COVID-19, thyroid gland, nonsuppurative granulematous thyroiditis.

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Mortality Prediction of Patients with Cardiovascular Disease Using Medical Claims Data under Artificial Intelligence Architectures: Validation Study (Preprint)

JMIR Medical Informatics ◽

10.2196/25000 ◽

2020 ◽

Author(s):

Linh Tran ◽

Lianhua Chi ◽

Alessio Bonti ◽

Mohamed Abdelrazek ◽

Yi-Ping Phoebe Chen

Keyword(s):

Artificial Intelligence ◽

Cardiovascular Disease ◽

Validation Study ◽

Claims Data ◽

Mortality Prediction ◽

Medical Claims

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Abstract 15772: Cardiovascular Hospitalizations and Procedures Plummet Nationwide During Covid-19 - an Analysis of US Medical Claims

Circulation ◽

10.1161/circ.142.suppl_3.15772 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Monica R Shah ◽

Tanya F Partridge ◽

Xiaoqing Xue ◽

Justin L Gregg

Keyword(s):

Claims Data ◽

Private Insurance ◽

National Level ◽

Regional Studies ◽

Bayesian Hierarchical ◽

Medical Claims ◽

Equivalent Time ◽

Time Period ◽

The Us ◽

National Trends

Introduction: Regional studies have reported a decline in cardiovascular (CV) hospitalizations and procedures with the onset of the coronavirus disease-2019 (COVID-19) pandemic. Factors may include patient reluctance to seek care and de-prioritization of approvals for CV admissions by hospitals. We wanted to assess these observations at a national level. Hypothesis: To examine national trends in CV hospitalizations for acute myocardial infarction (AMI), unstable angina (USA), and heart failure (HF), as well as left heart catheterizations (LHC), using US medical claims data. Methods: We interrogated IQVIA US Claims data, a verified source, from Jan 2019 to May 2020 (214 million patients; 76% private insurance claims, 19% Medicare claims, 5% Medicaid claims). Since confirmed COVID-19 cases in the US began rising in Mar 2020, this was used as reference point to identify cohorts for comparison. Trends in volumes of hospitalizations for key CV events (AMI, USA, and HF) and LHC were compared from Mar 1 to May 8, 2020 to the equivalent time period in 2019. We used a Bayesian hierarchical model to assess trends. Results: From Mar to May 2020, compared to 2019, there were significantly fewer hospitalizations for: key CV events (1,110,492 vs. 1,487,558; p=0.0016); AMI (277,615 vs. 412,235; p=0.0002); USA (1,007 vs. 1,688, p=0.1245); and, HF (831,870 vs. 1,073,635; p=0.0036). There were significantly fewer LHC (118,393 vs. 221,701; p=0.0002). As shown in the Figure, there was a significant decline in CV hospitalizations in 2020 compared to 2019. Conclusions: During the COVID-19 pandemic, CV hospitalizations have declined significantly in the US. We observed an ~25% drop in CV hospitalizations and an ~50% drop in LHC. To the best of our knowledge, this is the first national evaluation of trends in CV care during COVID-19 and validate concerns that acute CV care in the US has been delayed or deferred, potentially foreshadowing a surge of CV complications in the future.

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