Evidence map›Paper›PMID 38977199›Full record

ArticleJournal of the American Medical Directors Association2024

Identifying Dementia Severity Among People Living With Dementia Using Administrative Claims Data.

Priyanka Anand, Ye Zhang, Kerry Ngan, Mufaddal Mahesri, Gregory Brill, Dae H Kim, Kueiyiu Joshua Lin

Abstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
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

7 authors.

Priyanka AnandDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ye ZhangDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Kerry NganDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Mufaddal MahesriDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Gregory BrillDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Dae H KimHinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA.
Kueiyiu Joshua LinDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: jklin@bwh.harvard.edu.

Funding

Applications of Claims-Based Frailty Index to Advance Evidence for Frailty-Guided Decision-Making - Extension to ADRDR01AG071809 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI KIM, DAE HYUN · 2021 to 2025
$3.5M
A targeted analytical framework to optimize posthospitalization delirium pharmacotherapy in patients with Alzheimers disease and related dementiasR01AG081412 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI JOSHUA K LIN · 2023 to 2026
$3.4M
Effectiveness and Safety of Transcatheter Left Atrial Appendage Occlusion vs. Anticoagulation in Older Adults with Atrial Fibrillation and Alzheimer's Disease and Related dementiasR01AG075335 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI LIN, JOSHUA K · 2022 to 2025
$3.0M
Prospective Monitoring of Newly Approved Cardiovascular Drugs in Older Adults with FrailtyR01AG062713 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI KIM, DAE HYUN · 2019 to 2022
$2.8M
Developing scalable algorithms to incorporate unstructured electronic health records for causal inference based on real-world dataR01LM013204 · NLM · BRIGHAM AND WOMEN'S HOSPITAL · PI LIN, JOSHUA K · 2020 to 2024
$2.7M
Developing dynamic prognostic and risk-stratification models for informing prescribing decisions in older adults with Coronavirus Disease 2019RF1AG063381 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI LIN, JOSHUA K · 2019 to 2021
$2.7M
Mid-Career Mentoring Award For Patient-Oriented Research in Frailty and Health OutcomesK24AG073527 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI Dae Hyun Kim · 2022 to 2026
$862k
NIA NIH HHS K24 AG073527NIA NIH HHS R01 AG062713NIA NIH HHS R01 AG071809NIA NIH HHS R01 AG075335NIA NIH HHS R01 AG081412NIA NIH HHS RF1 AG063381NLM NIH HHS R01 LM013204
6 · The paper itself

Abstract

objectivesThere is currently no reliable tool for classifying dementia severity level based on administrative claims data. We aimed to develop a claims-based model to identify patients with severe dementia among a cohort of patients with dementia.

designRetrospective cohort study. SETTING AND

participantsWe identified people living with dementia (PLWD) in US Medicare claims data linked with the Minimum Data Set (MDS) and Outcome and Assessment Information Set (OASIS).

methodsSevere dementia was defined based on cognitive and functional status data available in the MDS and OASIS. The dataset was randomly divided into training (70%) and validation (30%) sets, and a logistic regression model was developed to predict severe dementia using baseline (assessed in the prior year) features selected by generalized linear mixed models (GLMMs) with least absolute shrinkage and selection operator (LASSO) regression. We assessed model performance by area under the receiver operating characteristic curve (AUROC), area under precision-recall curve (AUPRC), and precision and recall at various cutoff points, including Youden Index. We compared the model performance with and without using Synthetic Minority Oversampling Technique (SMOTE) to reduce the imbalance of the dataset.

resultsOur study cohort included 254,410 PLWD with 17,907 (7.0%) classified as having severe dementia. The AUROC of our primary model, without SMOTE, was 0.81 in the training and 0.80 in the validation set. In the validation set at the optimized Youden Index, the model had a sensitivity of 0.77 and specificity of 0.70. Using a SMOTE-balanced validation set, the model had an AUROC of 0.83, AUPRC of 0.80, sensitivity of 0.79, specificity of 0.74, positive predictive value of 0.75, and negative predictive value of 0.78 when at the optimized Youden Index. CONCLUSIONS AND IMPLICATIONS: Our claims-based algorithm to identify patients living with severe dementia can be useful for claims-based pharmacoepidemiologic and health services research.

Indexed as

DementiaMedicareSeverity of Illness IndexAdministrative Claims, HealthcareAgedAged, 80 and overCohort StudiesFemaleHumansInsurance Claim ReviewMaleRetrospective StudiesUnited StatesDementiaeffectivenessprediction modelsafetysevere dementia

Identifiers

PMID38977199
PMCPMC11368613

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.