Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD
Chad Moretz,1 Srinivas Annavarapu,1 Rakesh Luthra,2 Seth Goldfarb,1 Andrew Renda,3 Asif Shaikh,2 Shuchita Kaila2 1Comprehensive Health Insights, Louisville, KY, USA; 2Boehringer Ingelheim, Ridgefield, CT, USA; 3Humana Inc., Louisville, KY, USA Background: A claims-based model to predict patients l...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-02-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/spirometry-evaluation-to-assess-performance-of-a-claims-based-predicti-peer-reviewed-article-COPD |
| _version_ | 1818982802381602816 |
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| author | Moretz C Annavarapu S Luthra R Goldfarb S Renda A Shaikh A Kaila S |
| author_facet | Moretz C Annavarapu S Luthra R Goldfarb S Renda A Shaikh A Kaila S |
| author_sort | Moretz C |
| collection | DOAJ |
| description | Chad Moretz,1 Srinivas Annavarapu,1 Rakesh Luthra,2 Seth Goldfarb,1 Andrew Renda,3 Asif Shaikh,2 Shuchita Kaila2 1Comprehensive Health Insights, Louisville, KY, USA; 2Boehringer Ingelheim, Ridgefield, CT, USA; 3Humana Inc., Louisville, KY, USA Background: A claims-based model to predict patients likely to have undiagnosed COPD was developed by Moretz et al in 2015. This study aims to assess the performance of the aforementioned model using prospectively collected spirometry data.Methods: A study population aged 40–89 years enrolled in a Medicare Advantage plan with prescription drug coverage or commercial health plan and without a claim for COPD diagnosis was identified from April 1, 2012 to March 31, 2016 in the Humana claims database. This population was stratified into subjects likely or unlikely to have undiagnosed COPD using the claims-based predictive model. Subjects were randomly selected for spirometry evaluation of FEV1 and FVC. The predictive model was validated using airflow limitation ratio (FEV1/FVC <0.70).Results: A total of 218 subjects classified by the predictive model as likely and 331 not likely to have undiagnosed COPD completed spirometry evaluation. Those predicted to have undiagnosed COPD had a higher mean age (70.2 vs 67.9 years, P=0.0012) and a lower mean FEV1/FVC ratio (0.724 vs 0.753, P=0.0002) compared to those predicted not to have undiagnosed COPD. Performance metrics for the predictive model were: area under the curve =0.61, sensitivity =52.5%, specificity =64.6%, positive predictive value =33.5%, and negative predictive value =80.1%.Conclusion: The claims-based predictive model identifies those not at risk of having COPD eight out of ten times, and those who are likely to have COPD one out of three times. Keywords: COPD, exacerbation, predictive model, clinical validation, prevention |
| first_indexed | 2024-12-20T17:53:00Z |
| format | Article |
| id | doaj.art-2d44e23b8a3143868c90b6f856dff25f |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-20T17:53:00Z |
| publishDate | 2019-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-2d44e23b8a3143868c90b6f856dff25f2022-12-21T19:30:48ZengDove Medical PressInternational Journal of COPD1178-20052019-02-01Volume 1443944644117Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPDMoretz CAnnavarapu SLuthra RGoldfarb SRenda AShaikh AKaila SChad Moretz,1 Srinivas Annavarapu,1 Rakesh Luthra,2 Seth Goldfarb,1 Andrew Renda,3 Asif Shaikh,2 Shuchita Kaila2 1Comprehensive Health Insights, Louisville, KY, USA; 2Boehringer Ingelheim, Ridgefield, CT, USA; 3Humana Inc., Louisville, KY, USA Background: A claims-based model to predict patients likely to have undiagnosed COPD was developed by Moretz et al in 2015. This study aims to assess the performance of the aforementioned model using prospectively collected spirometry data.Methods: A study population aged 40–89 years enrolled in a Medicare Advantage plan with prescription drug coverage or commercial health plan and without a claim for COPD diagnosis was identified from April 1, 2012 to March 31, 2016 in the Humana claims database. This population was stratified into subjects likely or unlikely to have undiagnosed COPD using the claims-based predictive model. Subjects were randomly selected for spirometry evaluation of FEV1 and FVC. The predictive model was validated using airflow limitation ratio (FEV1/FVC <0.70).Results: A total of 218 subjects classified by the predictive model as likely and 331 not likely to have undiagnosed COPD completed spirometry evaluation. Those predicted to have undiagnosed COPD had a higher mean age (70.2 vs 67.9 years, P=0.0012) and a lower mean FEV1/FVC ratio (0.724 vs 0.753, P=0.0002) compared to those predicted not to have undiagnosed COPD. Performance metrics for the predictive model were: area under the curve =0.61, sensitivity =52.5%, specificity =64.6%, positive predictive value =33.5%, and negative predictive value =80.1%.Conclusion: The claims-based predictive model identifies those not at risk of having COPD eight out of ten times, and those who are likely to have COPD one out of three times. Keywords: COPD, exacerbation, predictive model, clinical validation, preventionhttps://www.dovepress.com/spirometry-evaluation-to-assess-performance-of-a-claims-based-predicti-peer-reviewed-article-COPDCOPDexacerbationpredictive modelclinical validationprevention |
| spellingShingle | Moretz C Annavarapu S Luthra R Goldfarb S Renda A Shaikh A Kaila S Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD International Journal of COPD COPD exacerbation predictive model clinical validation prevention |
| title | Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD |
| title_full | Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD |
| title_fullStr | Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD |
| title_full_unstemmed | Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD |
| title_short | Spirometry evaluation to assess performance of a claims-based predictive model identifying patients with undiagnosed COPD |
| title_sort | spirometry evaluation to assess performance of a claims based predictive model identifying patients with undiagnosed copd |
| topic | COPD exacerbation predictive model clinical validation prevention |
| url | https://www.dovepress.com/spirometry-evaluation-to-assess-performance-of-a-claims-based-predicti-peer-reviewed-article-COPD |
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