Michelle Dawson posts
Structured cited links
James P Burke, Anjali Jain, Wenya Yang, Jonathan P Kelly, Marygrace Kaiser, Laura Becker, Lindsay Lawer, Craig J Newschaffer (2014). Does a claims diagnosis of autism mean a true case?. Autism, 18(3), 321-330. SAGE Publications.
Abstract
The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis code (n = 182), (b) one claim with an autism spectrum disorder diagnosis code (n = 190), and (c) those who had no claims for autism spectrum disorder but had claims for other developmental or neurological conditions (n = 60). The algorithm-based diagnoses were compared with documented autism spectrum disorders in the medical charts. The algorithm requiring more than or equal to two claims for autism spectrum disorder generated a positive predictive value of 87.4%, which suggests that such an algorithm is a valid means to identify true autism spectrum disorder cases in claims data.
Study authors in this cited reference