EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network

Objectives: To evaluate the performance characteristics of the ICD-10-CM diagnosis code, U07.1, in identifying COVID-19 cases in administrative claims data. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid amplification test (NAAT) results in linked electronic health records...

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Autores:
Moll, K
Hobbi, S
Zhou, CK
Fingar, K
Burrell, T
Hernandez-Medina, V
Alawar, N
Anderson, SA
Wong, HL
Obidi, J
Shoaibi, A
Tipo de recurso:
Article of investigation
Fecha de publicación:
2022
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
eng
OAI Identifier:
oai:repositorio.cuc.edu.co:11323/10720
Acceso en línea:
https://hdl.handle.net/11323/10720
https://repositorio.cuc.edu.co/
Palabra clave:
COVID
Sars-COV-2
ICD-10-CM
FDA
US
Rights
embargoedAccess
License
Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
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oai_identifier_str oai:repositorio.cuc.edu.co:11323/10720
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network_name_str REDICUC - Repositorio CUC
repository_id_str
dc.title.eng.fl_str_mv EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
title EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
spellingShingle EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
COVID
Sars-COV-2
ICD-10-CM
FDA
US
title_short EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
title_full EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
title_fullStr EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
title_full_unstemmed EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
title_sort EPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best network
dc.creator.fl_str_mv Moll, K
Hobbi, S
Zhou, CK
Fingar, K
Burrell, T
Hernandez-Medina, V
Alawar, N
Anderson, SA
Wong, HL
Obidi, J
Shoaibi, A
dc.contributor.author.none.fl_str_mv Moll, K
Hobbi, S
Zhou, CK
Fingar, K
Burrell, T
Hernandez-Medina, V
Alawar, N
Anderson, SA
Wong, HL
Obidi, J
Shoaibi, A
dc.subject.proposal.eng.fl_str_mv COVID
Sars-COV-2
ICD-10-CM
FDA
US
topic COVID
Sars-COV-2
ICD-10-CM
FDA
US
description Objectives: To evaluate the performance characteristics of the ICD-10-CM diagnosis code, U07.1, in identifying COVID-19 cases in administrative claims data. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid amplification test (NAAT) results in linked electronic health records (EHR) were used as the reference method. This study was conducted in the United States Food and Drug Administration (FDA) Biologics Effectiveness and Safety (BEST) network. Methods: Three study populations comprising different care episodes were identified from two linked claims-EHR databases, IBM® MarketScan® Explorys® commercial claims-EHR (CED) and OneFlorida Data Trust linked Medicaid-EHR, using: 1) COVID-19-related diagnoses, 2) SARS-CoV-2 NAAT procedures, and 3) all-cause hospitalizations. The presence or absence of U07.1 code in the claims portion of the database was verified by SARS-CoV-2 NAAT results in the EHR portion of the database. The positive predictive value (PPV) and negative predictive value (NPV) of U07.1 were estimated for each study population. Results: Study populations 1, 2 and 3 from CED consisted of 26,686, 26,095 and 2,564 episodes, respectively, and the corresponding number of episodes from OneFlorida was 29,117, 23,412, and 9,629. The PPV ranged from 79.6% to 95.1%, and the NPV ranged from 95.3% to 99.8% across populations and databases, with the highest PPV in population 3 (CED: 91.9%; OneFlorida: 93.1%). PPVs and NPVs did not vary substantially by age. PPVs in populations 1 and 2 fluctuated from April to June 2020 and stabilized in CED but remained unstable in the OneFlorida Medicaid population. NPVs were consistently .90% over time in each study population within both databases. Conclusions: ICD-10-CM code U07.1 performs well in identifying COVID-19 cases and non-cases among care-seeking populations in claims databases, suggesting U07.1 may be used in observational studies, including COVID-19 vaccine safety and effectiveness evaluations. Portability of these findings depends on study period, disease prevalence, and database characteristics.
publishDate 2022
dc.date.issued.none.fl_str_mv 2022
dc.date.available.none.fl_str_mv 2023
2024-02-16T20:22:14Z
dc.date.accessioned.none.fl_str_mv 2024-02-16T20:22:14Z
dc.type.spa.fl_str_mv Artículo de revista
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.content.spa.fl_str_mv Text
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dc.identifier.citation.spa.fl_str_mv K Moll, S Hobbi, CK Zhou, K Fingar, T Burrell, V Hernandez-Medina, N Alawar, SA Anderson, HL Wong, J Obidi, A Shoaibi, EPH154 Assessment of Performance Characteristics of COVID-19 ICD-10-CM Diagnosis Code U07.1 Using Sars-COV-2 Nucleic Acid Amplification Test Results in the US FDA Best Network, Value in Health, Volume 25, Issue 7, Supplement, 2022, Page S463, ISSN 1098-3015, https://doi.org/10.1016/j.jval.2022.04.905
dc.identifier.issn.spa.fl_str_mv 1098-3015
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/11323/10720
dc.identifier.doi.none.fl_str_mv 10.1016/j.jval.2022.04.905
dc.identifier.eissn.spa.fl_str_mv 1524-4733
dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC – Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
identifier_str_mv K Moll, S Hobbi, CK Zhou, K Fingar, T Burrell, V Hernandez-Medina, N Alawar, SA Anderson, HL Wong, J Obidi, A Shoaibi, EPH154 Assessment of Performance Characteristics of COVID-19 ICD-10-CM Diagnosis Code U07.1 Using Sars-COV-2 Nucleic Acid Amplification Test Results in the US FDA Best Network, Value in Health, Volume 25, Issue 7, Supplement, 2022, Page S463, ISSN 1098-3015, https://doi.org/10.1016/j.jval.2022.04.905
1098-3015
10.1016/j.jval.2022.04.905
1524-4733
Corporación Universidad de la Costa
REDICUC – Repositorio CUC
url https://hdl.handle.net/11323/10720
https://repositorio.cuc.edu.co/
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournal.spa.fl_str_mv Value in Health
dc.relation.citationstartpage.spa.fl_str_mv 463
dc.relation.citationissue.spa.fl_str_mv 7
dc.relation.citationvolume.spa.fl_str_mv 25
dc.rights.eng.fl_str_mv © 2022 Published by Elsevier Inc.
dc.rights.license.spa.fl_str_mv Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
dc.rights.uri.spa.fl_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
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dc.format.extent.spa.fl_str_mv 1 página
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dc.coverage.country.none.fl_str_mv Estados Unidos
dc.publisher.spa.fl_str_mv Elsevier Ltd.
dc.publisher.place.spa.fl_str_mv United Kingdom
dc.source.spa.fl_str_mv https://www-sciencedirect-com.ezproxy.cuc.edu.co/science/article/pii/S1098301522011068?via%3Dihub
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spelling Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)© 2022 Published by Elsevier Inc.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/embargoedAccesshttp://purl.org/coar/access_right/c_f1cfMoll, KHobbi, SZhou, CKFingar, KBurrell, THernandez-Medina, VAlawar, NAnderson, SAWong, HLObidi, JShoaibi, A2024-02-16T20:22:14Z20232024-02-16T20:22:14Z2022K Moll, S Hobbi, CK Zhou, K Fingar, T Burrell, V Hernandez-Medina, N Alawar, SA Anderson, HL Wong, J Obidi, A Shoaibi, EPH154 Assessment of Performance Characteristics of COVID-19 ICD-10-CM Diagnosis Code U07.1 Using Sars-COV-2 Nucleic Acid Amplification Test Results in the US FDA Best Network, Value in Health, Volume 25, Issue 7, Supplement, 2022, Page S463, ISSN 1098-3015, https://doi.org/10.1016/j.jval.2022.04.9051098-3015https://hdl.handle.net/11323/1072010.1016/j.jval.2022.04.9051524-4733Corporación Universidad de la CostaREDICUC – Repositorio CUChttps://repositorio.cuc.edu.co/Objectives: To evaluate the performance characteristics of the ICD-10-CM diagnosis code, U07.1, in identifying COVID-19 cases in administrative claims data. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid amplification test (NAAT) results in linked electronic health records (EHR) were used as the reference method. This study was conducted in the United States Food and Drug Administration (FDA) Biologics Effectiveness and Safety (BEST) network. Methods: Three study populations comprising different care episodes were identified from two linked claims-EHR databases, IBM® MarketScan® Explorys® commercial claims-EHR (CED) and OneFlorida Data Trust linked Medicaid-EHR, using: 1) COVID-19-related diagnoses, 2) SARS-CoV-2 NAAT procedures, and 3) all-cause hospitalizations. The presence or absence of U07.1 code in the claims portion of the database was verified by SARS-CoV-2 NAAT results in the EHR portion of the database. The positive predictive value (PPV) and negative predictive value (NPV) of U07.1 were estimated for each study population. Results: Study populations 1, 2 and 3 from CED consisted of 26,686, 26,095 and 2,564 episodes, respectively, and the corresponding number of episodes from OneFlorida was 29,117, 23,412, and 9,629. The PPV ranged from 79.6% to 95.1%, and the NPV ranged from 95.3% to 99.8% across populations and databases, with the highest PPV in population 3 (CED: 91.9%; OneFlorida: 93.1%). PPVs and NPVs did not vary substantially by age. PPVs in populations 1 and 2 fluctuated from April to June 2020 and stabilized in CED but remained unstable in the OneFlorida Medicaid population. NPVs were consistently .90% over time in each study population within both databases. Conclusions: ICD-10-CM code U07.1 performs well in identifying COVID-19 cases and non-cases among care-seeking populations in claims databases, suggesting U07.1 may be used in observational studies, including COVID-19 vaccine safety and effectiveness evaluations. Portability of these findings depends on study period, disease prevalence, and database characteristics.1 páginaapplication/pdfengElsevier Ltd.United Kingdomhttps://www-sciencedirect-com.ezproxy.cuc.edu.co/science/article/pii/S1098301522011068?via%3DihubEPH154 assessment of performance characteristics of covid-19 CIE-10-CM diagnosis code U07.1 using Sars-COV-2 nucleic acid amplification test results in the us fda best networkArtículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85Estados UnidosValue in Health463725COVIDSars-COV-2ICD-10-CMFDAUSPublicationORIGINALEPH154 Assessment of Performance Characteristics of COVID-19 ICD-10-CM Diagnosis Code U07.1 Using Sars-COV-2 Nucleic Acid.pdfEPH154 Assessment of Performance Characteristics of COVID-19 ICD-10-CM Diagnosis Code U07.1 Using Sars-COV-2 Nucleic 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y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.

d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:

i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.

ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, los consagrados por la SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.

e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, ACINPRO), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.

5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

7. Término.

a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.

b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.

8. Varios.

a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.

b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.

c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.

d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.
