Table 3.
Performance characteristics for claims algorithms in the hemodynamic diagnosis of PAH: Development cohort.
| Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Odds ratio* (95% CI) | C-statistic* (95% CI) | |
|---|---|---|---|---|---|---|
| Claims-based algorithms | ||||||
| ICD-9-CM codes 416.0 and 416.8 | – | – | 9.34 | – | ||
| ICD codes + at least one PAHRx | 67.44 | 86.91 | 34.67 | 96.29 | 13.61 (7.69–24.09) | 0.84 (0.79–0.90) |
| ICD codes + two or more classes PAHRx | 28.23 | 98.56 | 66.86 | 93.03 | 26.87 (11.43–63.14) | 0.66 (0.60–0.73) |
| EMR-based algorithms | ||||||
| ICD codes + EMR encounter dx | 76.85 | 77.07 | 25.65 | 97.00 | 11.16 (6.08–20.49) | 0.67 (0.63–0.72) |
| ICD codes + EMR encounter dx + echo | 76.85 | 78.20 | 26.63 | 97.04 | 11.91 (6.48–21.89) | 0.69 (0.64–0.73) |
| ICD codes + EMR encounter dx + echo + RHC | 76.85 | 91.44 | 48.04 | 97.46 | 35.38 (18.60–67.32) | 0.86 (0.82–0.90) |
| ICD codes + EMR encounter dx + echo + RHC + PAHRx | 67.44 | 96.93 | 69.35 | 96.66 | 65.52 (32.76–131.08) | 0.87 (0.82–0.93) |
| ICD codes + EMR encounter dx + PAHRx | 67.44 | 96.45 | 66.15 | 96.64 | 56.31 (28.72–110.40) | 0.87 (0.81–0.92) |
*
Odds ratio and C-statistic came from a logistic regression model with the predictor based on the algorithm.
dx, diagnosis; EMR, electronic medical records; RHC, right heart catheterization; PAHRx, PAH-specific therapies; PPV, positive predictive value; NPV, negative predictive value.