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An examination of Alzheimer's disease case definitions using Medicare claims and survey data
Lin PJ, Kaufer DI, Maciejewski ML, Ganguly R, Paul JE, Biddle AK.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2010-07-01
Topic: Health services, long-term care and technology
Background The prevalence and expenditure estimates of Alzheimer's disease (AD) from studies using one data source to define cases vary widely. The objectives of this study were to assess agreement between AD case definitions classified with Medicare claims and survey data and to provide insight into causes of widely varied expenditure estimates. Methods Data were obtained from the 1999-2004 Medicare Current Beneficiary Survey linked with Medicare claims (n = 57,669). Individuals with AD were identified by survey, diagnosis, use of an AD prescription medicine, or some combination thereof. We also explored how much health care and drug expenditures vary by AD case definition. Results The prevalence of AD differed significantly by case definition. Using survey report alone yielded more cases (n = 1,994 or 3.46%) than diagnosis codes alone (n = 1,589 or 2.76%) or Alzheimer's medication use alone (n = 1,160 or 2.01%). Agreement between case definitions was low, with kappa coefficients ranging from 0.37 to 0.40. Per capita health expenditures ranged from $16,547 to $24,937, and drug expenditures ranged from $2,303 to $3,519, depending on how AD was defined. Conclusions Different information sources yield widely varied prevalence and expenditure estimates. Although claims data provided a more objective means for identifying AD cases, survey report identified more cases, and pharmacy data also are an important source for case ascertainment. Using any single source will underestimate the prevalence and associated cost of AD. The wide range of AD cases identified by using different data sources demands caution interpreting cost-of-illness studies using single data sources.
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APA 7th
Lin, P. J., Kaufer, D. I., Maciejewski, M. L., Ganguly, R., Paul, J. E., & Biddle, A. K. (2010). An examination of Alzheimer's disease case definitions using Medicare claims and survey data. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1016/j.jalz.2009.09.001
Vancouver
Lin PJ, Kaufer DI, Maciejewski ML, Ganguly R, Paul JE, Biddle AK. An examination of Alzheimer's disease case definitions using Medicare claims and survey data. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2010. doi:10.1016/j.jalz.2009.09.001. PMID: 20434960.
BibTeX
@article{lin2010-20434960,
author = {Lin, P. J. and Kaufer, D. I. and Maciejewski, M. L. and Ganguly, R. and Paul, J. E. and Biddle, A. K.},
title = {{An examination of Alzheimer's disease case definitions using Medicare claims and survey data}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2010},
doi = {10.1016/j.jalz.2009.09.001},
pmid = {20434960},
url = {https://doi.org/10.1016/j.jalz.2009.09.001}
}
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Key findings
- Results The prevalence of AD differed significantly by case definition.
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Study details
- Participants57,669
- Effect sizeor 3.46; or 2.76; or 2.01
- Evidence strengthLow
How this study scored 55/100
Published in a leading specialty journal. Scored zero for study design and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 32 of the 58 points we could judge it on, which is 55 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 4 / 4 | 57,669 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20434960) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 32 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 32 of the 58 points we could judge it on is 55 out of 100. |
| Total | 55 / 100 | — |
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