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March 05, 2019; 92 (10) ArticleOpen Access

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

View ORCID ProfileWilliam 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, Stella Leung, Charity Evans, Shenzhen Yao, Nicholas G. LaRocca, on behalf of the United States Multiple Sclerosis Prevalence Workgroup (MSPWG)
First published February 15, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007043
William J. Culpepper
From 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.
PhD, MA
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  • ORCID record for William J. Culpepper
Ruth Ann Marrie
From 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.
MD, PhD
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Annette Langer-Gould
From 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.
MD, PhD
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Mitchell T. Wallin
From 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.
MD, MPH
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Jonathan D. Campbell
From 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.
PhD
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Lorene M. Nelson
From 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.
PhD
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Wendy E. Kaye
From 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.
PhD
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Laurie Wagner
From 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.
MPH
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Helen Tremlett
From 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.
PhD
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Lie H. Chen
From 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.
DrPH
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Stella Leung
From 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.
MSc
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Charity Evans
From 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.
PhD
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Shenzhen Yao
From 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.
MD, MSc
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Nicholas G. LaRocca
From 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.
PhD
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From 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.
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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, Stella Leung, Charity Evans, Shenzhen Yao, Nicholas G. LaRocca, on behalf of the United States Multiple Sclerosis Prevalence Workgroup (MSPWG)
Neurology Mar 2019, 92 (10) e1016-e1028; DOI: 10.1212/WNL.0000000000007043

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    Figure 1 Performance of algorithm MS_E-1 [(IP + OP + DMT) ≥ 3] stratified by sex across the VA, KPSC, and MB datasets

    (A) Men and women, (B) men only, and (C) women only.Data are presented as a proportion that can range between 0 and 1. DMT = disease-modifying therapy; IP = inpatient; KPSC = Kaiser Permanente Southern California; MB = Manitoba; MS = multiple sclerosis; NPV = negative predictive value; OP = outpatient; PPV = positive predictive value; VA = Department of Veterans Affairs.

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    Figure 2 Performance of algorithm MS_E-1 [(IP + OP + DMT) ≥ 3] stratified by age group across the VA, KPSC, and MB datasets

    (A) Sensitivity, (B) specificity, (C) positive predictive value, (D) negative predictive value, (E) accuracy, and (F) Youden J statistic.Data from Manitoba (MB) for the 55- to 64- and 64- to 74-year age groups are suppressed due to small cell sizes. Data are presented as a proportion that can range between 0 and 1. DMT = disease-modifying therapy; IP = inpatient; KPSC = Kaiser Permanente Southern California; MS = multiple sclerosis; NPV = negative predictive value; OP = outpatient; PPV = positive predictive value; VA = Department of Veterans Affairs.

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    Figure 3 Comparison of prevalence based on a 3- vs 10-year ascertainment period as of 2010 in the (A) VA and (B) MB datasets

    CI = confidence interval; MB = Manitoba; VA = Department of Veterans Affairs.

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    Figure 4 Comparison of prevalence based on a 3- vs 9-year ascertainment period as of 2015 in the IMS (validation) dataset

    CI = confidence interval; IMS = Intercontinental Marketing Services.

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