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  1. Sensitivity and positive predictive value of medicare part B physician claims for rheumatologic diagnoses and procedures.

    Article - En anglais


    To examine the sensitivity and positive predictive value of Medicare physician claims for select rheumatic conditions managed in rheumatology specialty practices.


    Eight rheumatologists in 3 states abstracted 378 patient office records to obtain information on diagnosis and office procedures.

    The Medicare Part B physician claims for these patient visits were obtained from the Health Care Financing Administration.

    The sensitivity of the claims data for a specific diagnosis was calculated as the proportion of all patients whose office records for a particular visit documented that diagnosis and who also had physician claims for that visit which identified that diagnosis.

    The positive predictive value was evaluated in a separate sample of 331 patient visits identified in Medicare physician claims.

    The positive predictive value of the claims data for a specific diagnosis was calculated as the proportion of patients with that diagnosis coded in the claims for a particular visit who also had the diagnosis documented in the medical record for that visit.


    Ninety percent of abstracted office medical records were matched successfully with Medicare physician claims.

    The sensitivity of the Medicare physician claims was 0.90 (95% confidence interval [CI] 0.85-0.95) for rheumatoid arthritis (RA), 0.85 (95% CI 0.73-0.97) for systemic lupus erythematosus (SLE), and 0.85 (95% CI 0.78-1.0) for aspiration or injection procedures. (...)

    Mots-clés Pascal : Rhumatologie, Médecin, Technique, Diagnostic, Système ostéoarticulaire pathologie, Homme, Sensibilité, Valeur prédictive, Méthodologie, Medicare

    Mots-clés Pascal anglais : Rheumatology, Physician, Technique, Diagnosis, Diseases of the osteoarticular system, Human, Sensitivity, Predictive value, Methodology

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0512495

    Code Inist : 002B30A05. Création : 13/02/1998.