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[O5–03–03]: LEVERAGING MEDICARE CLAIMS TO CHARACTERIZE DIAGNOSTIC PATHWAYS IN ALZHEIMER's DISEASE
Rezaul Karim Khandker, Vinay Mehta, Christopher Matthew Black, Tiffini Voss, Brady Dubin, Baishali M. Ambegaonkar, Mark Marsico. Alzheimer s & Dementia, 2017-07-01
Topic: Amyloid, tau and blood-test diagnosis
Real-world, administrative claims data is uniquely suited to help characterize the journey of Alzheimer's disease (AD) patients from the onset of disease symptoms through diagnosis and beyond. The primary aims of this analysis were to: (1) characterize the temporal relationship between diagnostic and treatment codes associated with AD; and (2) explore the pre-diagnostic claims record for the appearance of codes suggestive of AD-related symptoms. Medical and pharmacy claims data from a large, geographically diverse, commercial, US Medicare Advantage health plan, for the period 2009–2014, was used to identify cases of newly diagnosed AD. Beneficiaries with claims for AD-specific diagnostic codes and prescription fills for a medication indicated to treat AD were included in the analysis. Among the 4,039 beneficiaries identified for inclusion in the analysis: 31% received a treatment prior to their first Alzheimer's-specific diagnostic code, 14% received an AD diagnostic code prior to their first treatment; and 23% received their treatment and diagnostic codes within 60 days of one another. Thirty-percent of the diagnosed cohort had multiple diagnostic codes but no evidence of treatment at any time during the 48-month observation period (24 months prior to and after incident diagnosis). Notable gaps between treatment and diagnosis were observed. The median number of days between treatment and diagnosis among those receiving a treatment first was 577; the median number of days between diagnosis and treatment in those receiving a diagnosis first was 397. Sixty-three percent of the combined cohort had an average of 6.1 claims suggestive of AD-related symptoms (e.g. memory loss, mild cognitive impairment) before their incident diagnostic code. These data suggests there is considerable heterogeneity in the AD diagnostic and treatment pathways. While the first appearance of a diagnosis code is commonly used as the index date from which disease related health care use is attributed, measurable care-seeking behavior and therapy associated with AD begins much earlier. Further research is needed to better understand the factors influencing pathway variability and the risks associated with diagnostic and treatment delays.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Khandker, R. K., Mehta, V., Black, C. M., Voss, T., Dubin, B., Ambegaonkar, B. M., et al. (2017). [O5–03–03]: LEVERAGING MEDICARE CLAIMS TO CHARACTERIZE DIAGNOSTIC PATHWAYS IN ALZHEIMER's DISEASE. Alzheimer s & Dementia. https://doi.org/10.1016/j.jalz.2017.07.520
Vancouver
Khandker RK, Mehta V, Black CM, Voss T, Dubin B, Ambegaonkar BM, et al. [O5–03–03]: LEVERAGING MEDICARE CLAIMS TO CHARACTERIZE DIAGNOSTIC PATHWAYS IN ALZHEIMER's DISEASE. Alzheimer s & Dementia. 2017. doi:10.1016/j.jalz.2017.07.520.
BibTeX
@article{khandker2017-463f59b4,
author = {Khandker, Rezaul Karim and Mehta, Vinay and Black, Christopher Matthew and Voss, Tiffini and Dubin, Brady and Ambegaonkar, Baishali M. and Marsico, Mark},
title = {{[O5–03–03]: LEVERAGING MEDICARE CLAIMS TO CHARACTERIZE DIAGNOSTIC PATHWAYS IN ALZHEIMER's DISEASE}},
journal = {Alzheimer s \& Dementia},
year = {2017},
doi = {10.1016/j.jalz.2017.07.520},
url = {https://doi.org/10.1016/j.jalz.2017.07.520}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- The primary aims of this analysis were to: (1) characterize the temporal relationship between diagnostic and treatment codes associated with AD; and (2) explore the pre-diagnostic claims record for the appearance of codes suggestive of AD-related symptoms.
- While the first appearance of a diagnosis code is commonly used as the index date from which disease related health care use is attributed, measurable care-seeking behavior and therapy associated with AD begins much earlier.
- Further research is needed to better understand the factors influencing pathway variability and the risks associated with diagnostic and treatment delays.
Why it matters
This analysis of Medicare claims found gaps and inconsistencies between when Alzheimer's disease was diagnosed and when treatment was recorded, with care-seeking often beginning before the first diagnosis code. It describes diagnostic and treatment patterns in claims data and does not test any treatment, cure, or prevention.
Study details
- Evidence strengthModerate
How this study scored 27/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Mark Marsico: h-index 6 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Merck & Co., Inc., Rahway, NJ, USA (United States): institution h-index 926 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 27 / 100 | — |
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