期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 182, 期 9, 页码 808-819出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwv116
关键词
algorithms; bias (epidemiology); coronary disease; epidemiologic methods; Medicare
资金
- National Institutes of Health [U01 NS041588, R01 HL080477, K24 HL111154, T32 HL00745733]
We examined claims-based approaches for identifying a study population free of coronary heart disease (CHD) using data from 8,937 US blacks and whites enrolled during 2003-2007 in a prospective cohort study linked to Medicare claims. Our goal was to minimize the percentage of persons at study entry with self-reported CHD (previous myocardial infarction or coronary revascularization). We assembled 6 cohorts without CHD claims by requiring 6 months, 1 year, or 2 years of continuous Medicare fee-for-service insurance coverage prior to study entry and using either a fixed-window or all-available look-back period. We examined adding CHD-related claims to our base algorithm, which included claims for myocardial infarction and coronary revascularization. Using a 6-month fixed window look-back period, 17.8% of participants without claims in the base algorithm reported having CHD. This was reduced to 3.6% using an all-available look-back period and adding other CHD claims to the base algorithm. Among cohorts using all-available look-back periods, increasing the length of continuous coverage from 6 months to 1 or 2 years reduced the sample size available without lowering the percentage of persons with self-reported CHD. This analysis demonstrates approaches for developing a CHD-free cohort using Medicare claims.
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