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

AbstractOBJECTIVES:
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.
AuthorsVin-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, TAIPAI Study Group
JournalJournal of clinical epidemiology (J Clin Epidemiol) Vol. 67 Issue 10 Pg. 1139-49 (Oct 2014) ISSN: 1878-5921 [Electronic] United States
PMID25034196 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Mineralocorticoid Receptor Antagonists
Topics
  • Adult
  • Aged
  • Algorithms
  • Drug Prescriptions (statistics & numerical data)
  • Female
  • Humans
  • Hyperaldosteronism (diagnosis, drug therapy)
  • Insurance, Health, Reimbursement
  • Male
  • Medical Records
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists (therapeutic use)
  • Reproducibility of Results
  • Taiwan

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