ERIC Number: EJ1019514
Record Type: Journal
Publication Date: 2014-Apr
Abstractor: As Provided
Does a Claims Diagnosis of Autism Mean a True Case?
Burke, James P.; Jain, Anjali; Yang, Wenya; Kelly, Jonathan P.; Kaiser, Marygrace; Becker, Laura; Lawer, Lindsay; Newschaffer, Craig J.
Autism: The International Journal of Research and Practice, v18 n3 p321-330 Apr 2014
The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis code (n = 182), (b) one claim with an autism spectrum disorder diagnosis code (n = 190), and (c) those who had no claims for autism spectrum disorder but had claims for other developmental or neurological conditions (n = 60). The algorithm-based diagnoses were compared with documented autism spectrum disorders in the medical charts. The algorithm requiring more than or equal to two claims for autism spectrum disorder generated a positive predictive value of 87.4%, which suggests that such an algorithm is a valid means to identify true autism spectrum disorder cases in claims data.
Descriptors: Autism, Pervasive Developmental Disorders, Disability Identification, Children, Adolescents, Sampling, Comorbidity, Medical Evaluation, Records (Forms), Health Insurance
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
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