Evidence map›Paper›PMID 30770432›Full record

ArticleNeurology2019

Validation of an algorithm for identifying MS cases in administrative health claims datasets.

William J Culpepper, Ruth Ann Marrie, Annette Langer-Gould, Mitchell T Wallin, Jonathan D Campbell, Lorene M Nelson, Wendy E Kaye, Laurie Wagner, Helen Tremlett, Lie H Chen and 5 more

Abstract readMulticenter StudyValidation Study
In one paragraph

Article in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed.

  1. Article
  2. Gynecologic complications of disease-modifying therapy in women with multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
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  7. Development and Validation of an Administrative Algorithm to Identify Veterans With Epilepsy.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2026
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

William J CulpepperFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY. William.Culpepper@va.gov.ORCID 0000-0002-8520-7400
Ruth Ann MarrieFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Annette Langer-GouldFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Mitchell T WallinFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Jonathan D CampbellFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Lorene M NelsonFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Wendy E KayeFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Laurie WagnerFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Helen TremlettFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Lie H ChenFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Stella LeungFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Charity EvansFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Shenzhen YaoFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
Nicholas G LaRoccaFrom the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
United States Multiple Sclerosis Prevalence Workgroup (MSPWG)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop a valid algorithm for identifying multiple sclerosis (MS) cases in administrative health claims (AHC) datasets.

methodsWe used 4 AHC datasets from the Veterans Administration (VA), Kaiser Permanente Southern California (KPSC), Manitoba (Canada), and Saskatchewan (Canada). In the VA, KPSC, and Manitoba, we tested the performance of candidate algorithms based on inpatient, outpatient, and disease-modifying therapy (DMT) claims compared to medical records review using sensitivity, specificity, positive and negative predictive values, and interrater reliability (Youden J statistic) both overall and stratified by sex and age. In Saskatchewan, we tested the algorithms in a cohort randomly selected from the general population.

resultsThe preferred algorithm required ≥3 MS-related claims from any combination of inpatient, outpatient, or DMT claims within a 1-year time period; a 2-year time period provided little gain in performance. Algorithms including DMT claims performed better than those that did not. Sensitivity (86.6%-96.0%), specificity (66.7%-99.0%), positive predictive value (95.4%-99.0%), and interrater reliability (Youden J = 0.60-0.92) were generally stable across datasets and across strata. Some variation in performance in the stratified analyses was observed but largely reflected changes in the composition of the strata. In Saskatchewan, the preferred algorithm had a sensitivity of 96%, specificity of 99%, positive predictive value of 99%, and negative predictive value of 96%.

conclusionsThe performance of each algorithm was remarkably consistent across datasets. The preferred algorithm required ≥3 MS-related claims from any combination of inpatient, outpatient, or DMT use within 1 year. We recommend this algorithm as the standard AHC case definition for MS.

Indexed as

AlgorithmsDiagnosis, Computer-AssistedMedical RecordsAdolescentAdultAgedDatabases, FactualFemaleHumansMaleMiddle AgedMultiple SclerosisObserver VariationPrevalenceRetrospective StudiesSensitivity and Specificity

Identifiers

PMID30770432
PMCPMC6442008

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