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Table 4 Positive predictive value of claims for asthma, COPD, Both or Neither in the 6 Months prior to initiation of a long-acting beta agonist, Overall and stratified by empirically-identified covariates

From: A cross-sectional study of the identification of prevalent asthma and chronic obstructive pulmonary disease among initiators of long-acting β-agonists in health insurance claims data

  

Number of confirmed cases

Medical records received

Positive predictive value (%)

95% CI (%)

Claim for asthma only

 

Overall

 

67

91

73.6

63.3, 82.3

Age, years

 

 20-39

 

19

24

79.2

57.8, 92.9

 40-64

 

45

62

72.6

59.8, 83.1

 > 64

 

3

5

60.0

14.7, 94.7

Sex

 

 Male

 

25

34

73.5

55.6, 87.1

 Female

 

42

57

73.7

60.3, 84.5

Top 3 Variables predictive of asthma confirmation

 

Outpatient visit, moderate complexity

Yes

42

51

82.4

69.1, 91.6

 

No

25

40

62.5

45.8, 77.3

Beta-adrenergic drug dispensing

Yes

53

66

80.3

68.7, 89.1

 

No

14

25

56.0

34.9, 75.6

West region

Yes

18

19

94.7

74.0, 99.9

 

No

49

72

68.1

56.0, 78.6

Claim for COPD only

 

Overall

 

75

92

81.5

72.1, 88.9

Age, years

 

 20-39

 

2

4

50.0

6.8, 93.2

 40-64

 

44

58

75.9

62.8, 86.1

 > 64

 

29

30

96.7

82.8, 99.9

Sex

 

 Male

 

38

42

90.5

77.4, 97.3

 Female

 

37

50

74.0

59.7, 86.4

Top 3 Variables predictive of COPD confirmation

 

65+ years of age

Yes

29

30

96.7

82.8, 99.9

 

No

46

62

74.2

61.5, 84.5

Inhaled anticholinergic drug dispensing

Yes

33

35

94.3

80.8, 99.3

 

No

42

57

73.7

60.3, 84.5

Radiologic examination, chest, 2 views, frontal and lateral

Yes

48

54

88.9

77.4, 95.8

 

No

27

38

71.1

54.1, 84.6

Claim for Asthma and COPD (PPV of asthma only)

 

Overall

 

40

104

38.5

29.1, 48.5

Age, years

 

 20-39

 

5

6

83.3

35.9, 99.6

 40-64

 

30

76

39.5

28.4, 52.4

 > 64

 

5

22

22.7

7.8, 45.4

Sex

 

 Male

 

19

44

43.2

28.3, 59.0

 Female

 

21

60

35.0

23.1, 48.4

Top 3 Variables predictive of asthma only among patients with claims-based COPD and asthma

     

Chronic airway obstruction, not elsewhere classified (ICD-9 496.xx)

Yes

20

76

26.3

16.9, 37.7

 

No

20

28

71.4

51.3, 86.8

General Bronchodilator Agents

Yes

6

35

17.1

6.6, 33.6

 

No

34

69

49.3

37.0, 61.6

Inhaled corticosteroid dispensing

Yes

9

39

23.1

11.1, 39.3

 

No

31

65

47.7

35.1, 60.5

No claims for asthma or COPD (PPV of asthma only)

     

Overall

 

24

83

28.9

19.5, 39.9

Age, years

     

 20-39

 

7

17

41.2

18.4, 67.1

 40-64

 

14

57

24.6

14.1, 37.8

 > 64

 

3

9

33.3

7.5, 70.1

Sex

     

 Male

 

8

32

25.0

11.5, 43.4

 Female

 

16

51

31.4

19.1, 45.9

Top 3 Variables predictive of asthma only among patients with neither claims-based COPD nor asthma

     

Lipid panel

Yes

1

23

4.4

0.1, 21.9

 

No

23

60

38.3

26.1, 51.8

Collection of venous blood by venipuncture

Yes

4

31

12.9

3.6, 29.8

 

No

20

52

38.5

25.3, 53.0

Macrolides

Yes

4

29

13.8

3.9, 31.7

 

No

20

54

37.0

24.3, 51.3

  1. COPD, chronic obstructive pulmonary disease.