Findings on Epilepsy Detailed by Investigators at Massachusetts General Hospital (Epilepsy Among Elderly Medicare Beneficiaries a Validated Approach To Identify Prevalent and Incident Epilepsy)

2019 APR 22 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Central Nervous System Diseases and Conditions - Epilepsy have been published. According to news reporting from Boston, Massachusetts, by NewsRx journalists, research stated, “Uncertain validity of epilepsy diagnoses within health insurance claims and other large datasets have hindered efforts to study and monitor care at the population level. To develop and validate prediction models using longitudinal Medicare administrative data to identify patients with actual epilepsy among those with the diagnosis.”

Financial supporters for this research include NIH, Harvard University Diversity Inclusion and Community Partnership program, Harvard University Diversity Inclusion and Community Partnership Faculty Fellowship Award, Epilepsy Foundation, Schwamm-Marriott Clinical Care Research Fellowship Award.

The news correspondents obtained a quote from the research from Massachusetts General Hospital, “Subjects, Measures: We used linked electronic health records and Medicare administrative data including claims to predict epilepsy status. A neurologist reviewed electronic health record data to assess epilepsy status in a stratified random sample of Medicare beneficiaries aged 65+ years between January 2012 and December 2014. We then reconstructed the full sample using inverse probability sampling weights. We developed prediction models using longitudinal Medicare data, then in a separate sample evaluated the predictive performance of each model, for example, area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. Of 20,945 patients in the reconstructed sample, 2.1% had confirmed epilepsy. The best-performing prediction model to identify prevalent epilepsy required epilepsy diagnoses with multiple claims at least 60 days apart, and epilepsy-specific drug claims: AUROC=0.93 [95% confidence interval (CI), 0.90-0.96], and with an 80% diagnostic threshold, sensitivity=87.8% (95% CI, 80.4%-93.2%), specificity= 98.4% (95% CI, 98.2%-98.5%). A similar model also performed well in predicting incident epilepsy (k=0.79; 95% CI, 0.66-0.92).”

According to the news reporters, the research concluded: “Prediction models using longitudinal Medicare data perform well in predicting incident and prevalent epilepsy status accurately.”

For more information on this research see: Epilepsy Among Elderly Medicare Beneficiaries a Validated Approach To Identify Prevalent and Incident Epilepsy. Medical Care, 2019;57(4):318-324. Medical Care can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Medical Care - http://journals.lww.com/lww-medicalcare/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting L.M.V.R. Moura, School of Medicine, Massachusetts General Hospital, Dept. of Neurology, Boston, MA 02115, United States. Additional authors for this research include J.R. Smith, L.H. Schwamm, A.J. Cole, D. Blacker, S. Hernandez-Diaz, C. Vogeli and J. Hsu.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/MLR.0000000000001072. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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