Administrative data on diagnosis and mineralocorticoid receptor antagonist prescription identified patients with primary aldosteronism in Taiwan

Vin Cent Wu, Ya Hui Hu, Che Hsiung Wu, Chih Chin Kao, Cheng Yi Wang, Wei Shen Yang, Hsiu Hao Lee, Yuan Shian Chang, Yen Hung Lin, Shuo Meng Wang, Likwang Chen, Kwan Dun Wu

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives To develop algorithms of locating patients with primary aldosteronism (PA) using insurance reimbursement data and to validate the algorithms using medical charts.

Study Design and Setting We extracted National Health Insurance (NHI) reimbursement data and medical charts in seven enrolled hospitals and analyzed diagnosis-related information for 1999-2010. The NHI codes PA as 255.1x, using the International Classification of Diseases, Ninth Revision, Clinical Modification. Confirmation of PA was based on suppression tests.

Results We reviewed medical charts for 1,094 cases with at least one PA diagnosis. PA was confirmed for 563 cases. Compared with patients with essential hypertension, PA patients had higher systolic blood pressure, higher aldosterone, lower renin activity, and lower potassium level (all P-values <0.05). An algorithm based on PA diagnosis reported in at least one hospital stay or three outpatient visits had modest performance (sensitivity = 0.94 and specificity = 0.20). The best additional condition for the algorithm was use of mineralocorticoid receptor antagonist (MRA; sensitivity = 0.89 and specificity = 0.88).

Conclusion Using information on PA diagnosis and MRA prescription reported in insurance claims data can precisely locate PA patients in high-risk groups. This algorithm can construct a reliable PA sample for conducting research in various fields, including epidemiology and clinical practice.

Original languageEnglish
Pages (from-to)1139-1149
Number of pages11
JournalJournal of Clinical Epidemiology
Volume67
Issue number10
DOIs
Publication statusPublished - Oct 1 2014

Fingerprint

Mineralocorticoid Receptor Antagonists
Hyperaldosteronism
Taiwan
Prescriptions
National Health Programs
Insurance
Health Insurance Reimbursement
Sensitivity and Specificity
International Classification of Diseases
Aldosterone
Renin
Length of Stay
Potassium
Epidemiology
Outpatients
Blood Pressure
Hypertension

Keywords

  • Adjudication
  • Administrative data
  • Medical chart review
  • Mineralocorticoid receptor antagonist
  • Primary aldosteronism
  • Validation

ASJC Scopus subject areas

  • Epidemiology

Cite this

Administrative data on diagnosis and mineralocorticoid receptor antagonist prescription identified patients with primary aldosteronism in Taiwan. / Wu, Vin Cent; Hu, Ya Hui; Wu, Che Hsiung; Kao, Chih Chin; Wang, Cheng Yi; Yang, Wei Shen; Lee, Hsiu Hao; Chang, Yuan Shian; Lin, Yen Hung; Wang, Shuo Meng; Chen, Likwang; Wu, Kwan Dun.

In: Journal of Clinical Epidemiology, Vol. 67, No. 10, 01.10.2014, p. 1139-1149.

Research output: Contribution to journalArticle

Wu, Vin Cent ; Hu, Ya Hui ; Wu, Che Hsiung ; Kao, Chih Chin ; Wang, Cheng Yi ; Yang, Wei Shen ; Lee, Hsiu Hao ; Chang, Yuan Shian ; Lin, Yen Hung ; Wang, Shuo Meng ; Chen, Likwang ; Wu, Kwan Dun. / Administrative data on diagnosis and mineralocorticoid receptor antagonist prescription identified patients with primary aldosteronism in Taiwan. In: Journal of Clinical Epidemiology. 2014 ; Vol. 67, No. 10. pp. 1139-1149.
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AU - Hu, Ya Hui

AU - Wu, Che Hsiung

AU - Kao, Chih Chin

AU - Wang, Cheng Yi

AU - Yang, Wei Shen

AU - Lee, Hsiu Hao

AU - Chang, Yuan Shian

AU - Lin, Yen Hung

AU - Wang, Shuo Meng

AU - Chen, Likwang

AU - Wu, Kwan Dun

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AB - Objectives To develop algorithms of locating patients with primary aldosteronism (PA) using insurance reimbursement data and to validate the algorithms using medical charts.Study Design and Setting We extracted National Health Insurance (NHI) reimbursement data and medical charts in seven enrolled hospitals and analyzed diagnosis-related information for 1999-2010. The NHI codes PA as 255.1x, using the International Classification of Diseases, Ninth Revision, Clinical Modification. Confirmation of PA was based on suppression tests.Results We reviewed medical charts for 1,094 cases with at least one PA diagnosis. PA was confirmed for 563 cases. Compared with patients with essential hypertension, PA patients had higher systolic blood pressure, higher aldosterone, lower renin activity, and lower potassium level (all P-values <0.05). An algorithm based on PA diagnosis reported in at least one hospital stay or three outpatient visits had modest performance (sensitivity = 0.94 and specificity = 0.20). The best additional condition for the algorithm was use of mineralocorticoid receptor antagonist (MRA; sensitivity = 0.89 and specificity = 0.88).Conclusion Using information on PA diagnosis and MRA prescription reported in insurance claims data can precisely locate PA patients in high-risk groups. This algorithm can construct a reliable PA sample for conducting research in various fields, including epidemiology and clinical practice.

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