{"id":13183,"date":"2023-03-14T00:00:00","date_gmt":"2023-03-14T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/publications\/journal-articles\/comparison-of-fracture-identification-using-different-definitions-in-healthcare-administrative-claims-data\/"},"modified":"2023-07-21T13:54:53","modified_gmt":"2023-07-21T17:54:53","slug":"comparison-of-fracture-identification-using-different-definitions-in-healthcare-administrative-claims-data","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/comparison-of-fracture-identification-using-different-definitions-in-healthcare-administrative-claims-data\/","title":{"rendered":"Comparison of fracture identification using different definitions in healthcare administrative (claims) data"},"content":{"rendered":"

We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius\/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for \u22653 years. The most inclusive definition (hip: inpatient or emergency diagnosis; radius\/ulna: inpatient, emergency, or outpatient diagnosis) served as a referent to compare the number and proportion of fractures captured. In sensitivity analyses, we considered a 180-day washout, excluded fractures associated with trauma; and hip only, excluded: (1) subtrochanteric fractures, and (2) hip replacement procedures. Hip fractures varied by definition in number (52\u20138058) and incidence (0.7\u2013111.8\/10,000 person-years). The second most inclusive definition required one inpatient diagnosis and identified 8% fewer hip fractures than the referent. Excluding hip replacements missed 33% of hip fractures relative to the primary analysis. Radius\/ulna fractures also ranged in number (1589\u20136797) and incidence (22.0\u201394.3\/10,000 person-years). Outpatient data were important, when restricted to inpatient or emergency data, only 78% of radius\/ulna fractures were identified. Other than hip replacement procedures, sensitivity analyses had minimal impact on fracture identification. Analyses were replicated in a cohort of patients treated with long-term glucocorticoids. This study highlights the importance and impact of coding decisions on fracture outcome definitions. Further research is warranted to inform best practice in fracture outcome identification.<\/p>\n","protected":false},"excerpt":{"rendered":"

We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius\/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for \u22653 years. The most inclusive definition […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[59],"migration-helper-qa-sample-set":[],"class_list":["post-13183","journal_article","type-journal_article","status-publish","hentry","topic-data-science"],"acf":{"citation":"Konstantelos N, Burden AM, Cheung AM, Kim S, Grootendorst P, Cadarette SM. Pharmacy<\/em>. 2023; 11(2):53. Epub 2023 Mar 14.","source_url":"https:\/\/www.mdpi.com\/2226-4787\/11\/2\/53","ices_scientist":[1204],"site":[6735],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"745751BF-9874-492C-B9A0-642393D233C7","sitecore_item_name":"Comparison-of-fracture-identification-using-different-definitions","sitecore_field_values":"{\r\n \"Title\": \"Comparison of fracture identification using different definitions in healthcare administrative (claims) data\",\r\n \"Short title\": \"Comparison of fracture identification\",\r\n \"Summary\": \"This study aimed to compare fracture rates estimated using thirteen hip and seven radius\/ulna fracture definitions.\",\r\n \"Citation\": \"

Konstantelos N, Burden AM, Cheung AM, Kim S, Grootendorst P, Cadarette SM. Pharmacy<\/em>. 2023; 11(2):53. Epub 2023 Mar 14. DOI: https:\/\/doi.org\/10.3390\/pharmacy11020053<\/a><\/p>\",\r\n \"Abstract\": \"

We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius\/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for ≥3 years. The most inclusive definition (hip: inpatient or emergency diagnosis; radius\/ulna: inpatient, emergency, or outpatient diagnosis) served as a referent to compare the number and proportion of fractures captured. In sensitivity analyses, we considered a 180-day washout, excluded fractures associated with trauma; and hip only, excluded: (1) subtrochanteric fractures, and (2) hip replacement procedures. Hip fractures varied by definition in number (52–8058) and incidence (0.7–111.8\/10,000 person-years). The second most inclusive definition required one inpatient diagnosis and identified 8% fewer hip fractures than the referent. Excluding hip replacements missed 33% of hip fractures relative to the primary analysis. Radius\/ulna fractures also ranged in number (1589–6797) and incidence (22.0–94.3\/10,000 person-years). Outpatient data were important, when restricted to inpatient or emergency data, only 78% of radius\/ulna fractures were identified. Other than hip replacement procedures, sensitivity analyses had minimal impact on fracture identification. Analyses were replicated in a cohort of patients treated with long-term glucocorticoids. This study highlights the importance and impact of coding decisions on fracture outcome definitions. Further research is warranted to inform best practice in fracture outcome identification.<\/p>n

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