Development of a claims-based algorithm to identify potentially undiagnosed chronic migraine patients.
Cephalalgia
; 39(4): 465-476, 2019 04.
Article
en En
| MEDLINE
| ID: mdl-30854881
ABSTRACT
OBJECTIVE:
To develop a claims-based algorithm to identify undiagnosed chronic migraine among patients enrolled in a healthcare system.METHODS:
An observational study using claims and patient survey data was conducted in a large medical group. Eligible patients had an International Classification of Diseases, Ninth/Tenth Revision (ICD-9/10) migraine diagnosis, without a chronic migraine diagnosis, in the 12 months before screening and did not have a migraine-related onabotulinumtoxinA claim in the 12 months before enrollment. Trained clinicians administered a semi-structured diagnostic interview, which served as the gold standard to diagnose chronic migraine, to enrolled patients. Potential claims-based predictors of chronic migraine that differentiated semi-structured diagnostic interview-positive (chronic migraine) and semi-structured diagnostic interview-negative (non-chronic migraine) patients were identified in bivariate analyses for inclusion in a logistic regression model.RESULTS:
The final sample included 108 patients (chronic migraine = 64; non-chronic migraine = 44). Four significant predictors for chronic migraine were identified using claims in the 12 months before enrollment ≥15 versus <15 claims for acute treatment of migraine, including opioids (odds ratio = 5.87 [95% confidence interval 1.34-25.63]); ≥24 versus <24 healthcare visits (odds ratio = 2.80 [confidence interval 1.08-7.25]); female versus male sex (odds ratio = 9.17 [confidence interval 1.26-66.50); claims for ≥2 versus 0 unique migraine preventive classes (odds ratio = 4.39 [confidence interval 1.19-16.22]). Model sensitivity was 78.1%; specificity was 72.7%.CONCLUSIONS:
The claims-based algorithm identified undiagnosed chronic migraine with sufficient sensitivity and specificity to have potential utility as a chronic migraine case-finding tool using health claims data. Research to further validate the algorithm is recommended.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Revisión de Utilización de Seguros
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Algoritmos
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Trastornos Migrañosos
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Qualitative_research
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cephalalgia
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos