Using administrative claims data to estimate virologic failure rates among human immunodeficiency virus-infected patients with antiretroviral regimen switches.
Med Decis Making
; 32(1): 118-31, 2012.
Article
em En
| MEDLINE
| ID: mdl-21512188
ABSTRACT
OBJECTIVE:
To develop and validate a claims signature model that estimates proportions of HIV-infected patients in administrative claims databases who switched combination antiretroviral therapy (cART) regimens because of virologic failure.METHODS:
The authors used an HIV-specific registry (development data set) to develop logistic regression models to estimate odds of virologic failure among patients who switched cART regimens. Models were validated in a sample of administrative claims with laboratory values (validation data set). The final model was applied to an application data set as a worked example.RESULTS:
There were 1691, 1073, and 3954 eligible patients with cART switches in the development, validation, and application data sets, respectively. In the development data set, virologic failure before a switch was observed 21.8% of the time. Failure more likely caused the regimen switch among patients who were treatment experienced, had been receiving their baseline regimen for > 180 days, had ≥ 2 or more physician visits within 90 days, had > 1 HIV RNA or CD4 cell count test within 30 days, had any resistance test within 180 days, or had a change in regimen type. The final model had good discriminatory ability (C = 0.885) and fit (Hosmer-Lemeshow P = 0.8692). Failure was estimated to occur in 18.9% (v. 18.6% observed) of switches in the validation data set and 13.8% in the application data set.CONCLUSIONS:
This claims signature model allows payers to use claims data to estimate virologic failure rates in their patient populations, thereby better understanding plan costs of failure.
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Infecções por HIV
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HIV-1
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Antirretrovirais
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Relação Dose-Resposta a Droga
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Med Decis Making
Ano de publicação:
2012
Tipo de documento:
Article