Table 2.
Sensitivity, positive predictive value, and agreement of M05 and M06 diagnosis codes in RA patients compared to various lab-based gold standards
| RISE EHR | MarketScan administrative claims | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Lab test result (gold standard): definition of positive | N, patients | Sensitivity | PPV | Kappa | N | Sensitivity | PPV | Kappa | |
| M05 | Any positive RF: ≥ 14 or positive | 31,827 | 0.82 (0.81, 0.82) | 0.81 (0.80, 0.82) | 0.61 (0.60, 0.62) | 1115 | 0.73 (0.70, 0.76) | 0.84 (0.81, 0.87) | 0.45 (0.40, 0.50) |
| High positive RF: ≥ 42* | 24,224 | 0.86 (0.86, 0.87) | 0.73 (0.72, 0.73) | 0.61 (0.60, 0.62) | 840 | 0.74 (0.69, 0.78) | 0.72 (0.68, 0.76) | 0.44 (0.38, 0.50) | |
| Any positive anti-CCP: ≥ 20 or positive | 38,859 | 0.76 (0.75, 0.76) | 0.68 (0.67, 0.69) | 0.41 (0.40, 0.42) | 261 | 0.64 (0.56, 0.71) | 0.76 (0.68, 0.83) | 0.24 (0.13, 0.36) | |
| High-positive anti-CCP ≥ 60** | 34,490 | 0.82 (0.81, 0.82) | 0.63 (0.63, 0.64) | 0.45 (0.44, 0.46) | 201 | 0.66 (0.57, 0.75) | 0.67 (0.57, 0.76) | 0.29 (0.16, 0.42) | |
| Any positive RF or anti-CCP (RF ≥ 14 or positive) or (anti-CCP ≥ 20 or positive) | 43,581 | 0.76 (0.75, 0.76) | 0.82 (0.82, 0.83) | 0.51 (0.51, 0.52) | 1185 | 0.73 (0.69, 0.77) | 0.84 (0.81, 0.87) | 0.45 (0.40, 0.50) | |
| Any high-positive RF or anti-CCP: RF ≥ 42 or anti-CCP ≥ 60*** | 40,452 | 0.83 (0.82, 0.83) | 0.71 (0.70, 0.71) | 0.53 (0.52, 0.54) | 927 | 0.73 (0.69–0.77) | 0.71 (0.67–0.75) | 0.42 (0.36, 0.48) | |
| M06 | Not RF-positive | 31,827 | 0.80 (0.79, 0.80) | 0.80 (0.79, 0.81) | 0.61 (0.60, 0.62) | 1115 | 0.74 (0.7, 0.79) | 0.59 (0.55, 0.64) | 0.45 (0.40, 0.50) |
| Not RF high-positive* | 24,224 | 0.76 (0.76, 0.77) | 0.89 (0.88, 0.89) | 0.61 (0.60, 0.62) | 840 | 0.70 (0.65, 0.75) | 0.72 (0.67, 0.76) | 0.44 (0.38, 0.50) | |
| Not positive for anti-CCP | 38,859 | 0.66 (0.65, 0.66) | 0.74 (0.73, 0.74) | 0.41 (0.40, 0.42) | 261 | 0.63 (0.52, 0.73) | 0.48 (0.39, 0.57) | 0.24 (0.13, 0.36) | |
| Not high-positive for Anti-CCP** | 34,490 | 0.65 (0.65, 0.66) | 0.83 (0.82, 0.83) | 0.45 (0.44, 0.46) | 201 | 0.63 (0.52, 0.73) | 0.62 (0.52, 0.72) | 0.29 (0.16, 0.42) | |
| Not positive for RF or Anti-CCP-positive | 43,581 | 0.77 (0.76, 0.77) | 0.69 (0.68, 0.69) | 0.51 (0.51, 0.52) | 1185 | 0.74 (0.70, 0.79) | 0.60 (0.56, 0.64) | 0.45 (0.40, 0.50) | |
| Not high-positive for RF or anti-CCP*** | 40,452 | 0.71 (0.70, 0.71) | 0.83 (0.82, 0.83) | 0.53 (0.52, 0.54) | 927 | 0.69 (0.64, 0.73) | 0.71 (0.67, 0.76) | 0.42 (0.36, 0.48) | |
RA rheumatoid arthritis, EHR electronic health record, PPV positive predictive value
*Excluded those 14 < RF < 42
**Excluded those 20 < anti-CCP < 60
***Excluded those 14 < <RF < 42 and 20 < anti-CCP < 60