External validation and improvement of an algorithm that identifies multiple sclerosis relapses in the French national healthcare claims database.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Carcaillon-Bentata Laure, Abouelfath Abdelilah, Lignot-Maleyran Séverine, Lassalle Régis, Jové Jérémy, Blin Patrick, Berger Eric, Bourre Bertrand, Camdessanche Jean Philippe, Casez Olivier, Ciron Jonathan, David Thomas, De Seze Jerome, Defer Gilles, Doghri Inès, Santos Amélie Dos, Hankiewicz Karolina, Heinzlef Olivier, Labauge Pierre, Page Emmanuelle Le, Lebrun-Frenay Christine, Leclancher Alexandre, Louapre Céline, Manchon Eric, Mathey Guillaume, Montcuquet Alexis, Papeix Caroline, Pelletier Jean, Pottier Corinne, Ruet Aurélie, Sarov-Riviere Mariana, Vukusic Sandra, Magy Laurent, Moulin Maximilien, Brochet Bruno, Casey Romain, Leray Emmanuelle, OFSEP Investigators
Аннотация
METHODS: Clinical data from the French MS registry (OFSEP) linked to the SNDS were used. The cohort included MS patients with a first DMT claim between July 2015 and December 2017, naive to any MS treatment, followed until December 2018 (n=1,640). The initial relapse algorithm combined high-dose corticosteroid prescriptions and hospitalization duration. Incidence of the first relapse identified in the SNDS was compared with OFSEP confirmed relapses that have been treated by corticosteroid or hospitalized (gold standard). Performances were estimated using Sensitivity, Specificity, PPV, NPV. Algorithm were reevaluated after revision of its criteria based on experts' review of false positive and negative cases' claims, and finally after adding non-naive MS patients (n=9,966).
RESULTS: The performances of the initial algorithm were Specificity 85.2%, Sensitivity 74.0%, NPV 89.8%, PPV 65.3%. After revision of corticosteroid dosages and hospitalization durations thresholds, performance slightly improved: 85.0%, 75.4%, 90.2%, 65.3%, respectively. When considering naive and non-naive MS patients, Sensitivity and NPV stayed similar (75.1% and 91.6%) while Specificity and PPV decreased (81.8% and 55.4%).
CONCLUSION: The final algorithm of treated/hospitalized relapses can be applied accurately in naïve MS patients initiating a DMT, in the SNDS and likely in other claims databases after adapting to each country's reimbursement and care practices.