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21. PHS 398 (Rev. 9/04), Continuation Page (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/pdf/administrative-data-validity_research.pdf
    January 01, 2007 - Background: Probably the most important concern with using claims data for research is its validity. … Based on these and other studies, our experience suggests that in any study using claims data, with … Utilizing CMS data, investigators identified inpatient diagnoses of SCD/VA via presence of an ICD-9 claims … Presence of a claims diagnosis from the codeset was considered a positive “test” for SCD/VA. … This may be improved by focusing on primary claims diagnoses only or utilizing, as true cases, only

22. PHS 398 (Rev. 9/04), Continuation Page (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/upenn-final-report-2005-certs-ce-supplement.pdf
    January 01, 2005 - Background: Probably the most important concern with using claims data for research is its validity. … Based on these and other studies, our experience suggests that in any study using claims data, with … Utilizing CMS data, investigators identified inpatient diagnoses of SCD/VA via presence of an ICD-9 claims … Presence of a claims diagnosis from the codeset was considered a positive “test” for SCD/VA. … This may be improved by focusing on primary claims diagnoses only or utilizing, as true cases, only

23. Testing Cancer Quality Measures for End-of-Life Care | Effective Health Care (EHC) Program
    effectivehealthcare.ahrq.gov/products/cancer-end-of-life-quality-meaures/research
    May 17, 2010 - Linked Medicare claims, pharmaceutical claims, and cancer registry data from 1994 - 2003 for New Jersey … Methods Data Sources Linked Medicare claims, pharmaceutical claims and cancer registry data for … Evaluating claims-based indicators of the intensity of end-of-life cancer care. … Coding accuracy of administrative drug claims in the Ontario Drug Benefit database. … Medicare claims ICD-9 diagnosis codes DRGs (36) Codes are documented in Appendix C.

24. REQUEST FOR TASK ORDER (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/pdf/cancer-end-of-life-quality-meaures_research.pdf
    April 01, 2010 - Linked Medicare claims, pharmaceutical claims, and cancer registry data from 1994 - 2003 for New Jersey … The purpose of this analysis is to further evaluate claims-based indicators of the quality of care at … , pharmaceutical claims and cancer registry data for the period January 1, 1994 through May 31, 2003 … Evaluating claims-based indicators of the intensity of end-of-life cancer care. … Coding accuracy of administrative drug claims in the Ontario Drug Benefit database.

25. Ebctandcfinal (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/ebctandcfinal.pdf
    June 05, 2012 - employees, and agents (including but not limited to, any judges or evaluators of the entries) from any claims … ) Challenge; and,  Indemnify, defend and hold harmless the sponsors from and against any and all claims

26. Prompt Reduction in Use of Medications for Comorbid Conditions After Bariatric Surgery | Effective Health Care (EHC) Program
    effectivehealthcare.ahrq.gov/products/bariatric-surgery/research
    July 30, 2010 - We requested claims on members who met any of these inclusion criteria during 2002 through 2005: (1) … These diagnoses were identified in the claims by Common Procedural Terminology (CPT) codes, International … Also, with the use of pharmacy claims, we were less likely to miss comorbid conditions that were under … Our estimates of medication use were based on pharmacy claims. … For those persons whose claims-based propensity score fell into the highest 5% percentile, fully 96%

27. Executive Summary for CER No. 258_Diagnostic Errors in the Emergency Department: A Systematic Review (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-258-diagnostic-errors-summary.pdf
    December 01, 2022 - Results for Key Question 1 relied heavily on two large studies (one of medical malpractice claims, the … Although there are clear biases in malpractice claims, there was a high degree of concordance between … claims and incident reports with respect to diseases causing serious harms. … Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from … An epidemiologic study of closed emergency department malpractice claims in a national database of

28. Reduction in Medication Use after Bariatric Surgery (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/pdf/bariatric-surgery_research.pdf
    June 01, 2010 - Data Acquisition We accessed claims data from seven Blue Cross Blue Shield health plans providing … We requested claims on members who met any of these inclusion criteria during 2002 through 2005: (1 … Our estimates of medication use were based on pharmacy claims. … We also used prescription drug claims information (NDC codes) to identify additional persons under … This very high specificity suggests that the propensity score can effectively be applied to claims

29. Geographic Variation in Carotid Endarterectomy and Carotid Stenting Among Medicare Beneficiaries, 2003-2006 | Effective Health Care (EHC) Program
    effectivehealthcare.ahrq.gov/products/cardiology-health-outcomes/research
    July 28, 2010 - We also obtained all claims for all beneficiaries who underwent carotid magnetic resonance angiography … The inpatient files contain institutional claims for facility costs covered under Medicare Part A. … The outpatient files contain claims from outpatient providers covered under Medicare Part B. … The carrier files contain claims from noninstitutional providers for services covered under Medicare … We included only claims filed during periods of fee-for-service coverage.

30. Cancer-Drugs-Utilization Research (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/pdf/cancer-drugs-utilization_research.pdf
    January 01, 2011 - types of cancer for which anticancer biologics are used, as identified in Medicare Parts B and D claims … 3 Table 1: Percentage of beneficiaries with specific cancer diagnoses, by ICD-9 subchapter, among claims … 25.00 8.09 † † † Suppressed to remain compliant with CMS’ small-sized cell privacy policy Includes claims … The Common Working File (CWF) was used to identify claims for biologics billed under Medicare Part … in Medicare Parts A and B FFS throughout the year; (b) used the CWF to extract all Parts A and B claims

31. S38 (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/s38.pdf
    October 01, 2007 - With available claims data, investigators can apply focused eligibility criteria to exclude subjects … An alternative approach is possible when trials are conducted within health care systems with claims … Certainly there are limitations as well as strengths associated with the use of automated claims data … Many claims data sets do not contain actual laboratory values. … Validation of diagnostic codes within medical services claims. J Clin Epidemiol. 2004;57:131–141.

32. Distributed Ambulatory Research in Therapeutics Network (DARTNet): Summary Report | Effective Health Care (EHC) Program
    effectivehealthcare.ahrq.gov/products/distributed-network-ambulatory-therapeutics/research
    July 28, 2009 - data sets created for other purposes, such as administrative data sets created to process insurance claims … Phase 1 used a commercially available, integrated medical claims database to examine the comparative … available, integrated medical claims databases could be used to answer key research questions related … treated, thus confounding all the outcomes of any claims data analysis. … Table 1 presents some of the clinical variables present in DARTNet data but not in claims data.

33. S13 (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/s13.pdf
    October 01, 2007 - difficult to measure and quan- tify,9 and other outcomes (eg, mild rashes) are not likely to appear in claims … Further, uncertain validity of diagnostic outcomes is a problem, especially when claims databases are … used.10 Inpatient hospital claims diagnoses are usually good representations of the corresponding discharge … A final example, as noted above, is the critical need in many claims studies for medical records to validate … Using a claims database to investigate drug-induced Stevens-Johnson syndrome.

34. S158 (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/s158.pdf
    October 01, 2007 - Failure to adjust for 5 potential confounders not measured in the administrative claims data (smoking … Some of these, however, are measured in claims data and a single unobserved con- founder would need to … Data Validation Study Error-Prone Claims Data Gold-Standard Claims and Survey Exposure X X X Demographics … Controlling for a wide variety of health indicators available in claims data (for a list, see Table 3 … The gold-standard PS that pre- dicted NSAID exposure based on claims data combined with interview data

35. Geographic Variation in Carotid Endarterectomy and Carotid Stenting Among Medicare Beneficiaries, 2003-2006 (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/pdf/cardiology-health-outcomes_research.pdf
    July 01, 2010 - We also obtained all claims for all beneficiaries who underwent carotid magnetic resonance angiography … The inpatient files contain institutional claims for facility costs covered under Medicare Part A. … The outpatient files contain claims from outpatient providers covered under Medicare Part B. … The carrier files contain claims from noninstitutional providers for services covered under Medicare … We included only claims filed during periods of fee-for-service coverage.

36. Data Points 16: Types of Prostate Radiation: Changes across time and geography in the use of prostate radiation technologies for newly diagnosed older cancer patients: 2006-2008 (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/pdf/prostate-cancer-radiation_research.pdf
    November 01, 2012 - cancer.8 In a study using the linked Surveillance, Epidemiology, and End Results (SEER) Medicare claims … be unrelated to use of CRT or IMRT.10 Therefore, national trends can be studied using Medicare claims … METHODS We used the Chronic Condition Ware- house (CCW) claims-based algorithm to identify men newly … received radiation therapy within 12 months of the first date suggestive of prostate cancer in the claims … radical prostatectomy within the 12 months of the first date suggestive of prostate cancer in the claims

37. Slide 1
    effectivehealthcare.ahrq.gov/sites/default/files/selection-of-data-sources-chapter-8.pptx
    January 01, 2013 - Of note, medication information captured in EMRs differs from data captured by pharmacy claims. … Presently, medical claims are most often coded using the International Classification of Disease (ICD … For outpatient encounters, the CPT is used for submitting claims for services. … When using these claims for research purposes, the validity of the coding is of the highest importance … Pharmacy Data Outpatient pharmacy data include claims submitted to insurance companies for payment, as

38. Real World Effectiveness of Carotid Artery Stenting (CAS) in Medicare Patients | Effective Health Care (EHC) Program
    effectivehealthcare.ahrq.gov/products/coronary-stents-effectiveness/abstract
    April 14, 2010 - Aim 6: Investigate the potential of linking imaging data with medical record and claims data and write … Medicaid Services (CMS) CAS registry; 2) the Society of Vascular Surgery (SVS-VR) data; 3) Medicare claims

39. S143 (pdf file)
    effectivehealthcare.ahrq.gov/sites/default/files/s143.pdf
    October 01, 2007 - members being statin initiators or noninitiators, and the outcome of AMI was identified on the basis of claims … Pharmacy dispensations of statins were identified from pharmacy claims by national drug code supplemented … consecutive dates, or an inpatient claim for AMI on a single day followed by a complete cessation of claims … Health services utilization data (such as claims data) may allow for the formation of reasonable proxies … An application of propensity score matching using claims data.

40. Bridging Knowledge Gaps in the Comparative Effectiveness of ACE Inhibitors and ARBs | Effective Health Care Program
    effectivehealthcare.ahrq.gov/products/ace-inhibitors-arbs-knowledge-gaps/research
    January 01, 2005 - Validity of claims-based definitions of left ventricular systolic dysfunction in Medicare patients.