Enhanced Data to Accelerate Complex Patient Comparative Effectiveness Research, 2006-2009 [United States]
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10 septembre 2013
- doi: 10.3886/ICPSR34639.v1
- 34639
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acute myocardial infarction (AMI) beneficiaries chronic illnesses comorbidity health health care medical care medical records Medicare patient care patients research statin strokeSujets proches
Scientific research Science research Science--ResearchCiter ce document
Elizabeth A. Chrischilles et al., « Enhanced Data to Accelerate Complex Patient Comparative Effectiveness Research, 2006-2009 [United States] », Inter-university Consortium for Political and Social Research, ID : 10.3886/ICPSR34639.v1
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Purpose: Develop an easy-to-use data product to facilitate comparative effectiveness research involving complex patients. Scope: Claims data can be difficult to use, requiring experience to most appropriately aggregate to the patient level and to create meaningful variables such as treatments, covariates, and endpoints. Easy to use data products will accelerate meaningful comparative effectiveness research (CER). Methods: This project used data from the Medicare Chronic Condition Data Warehouse for patients hospitalized with acute myocardial infarction (AMI) or stroke in 2007 with two-year follow-up and one-year pre-admission baseline. The project joined over 100 raw data files per condition to create research-ready person- and service-level analytic files, code templates, and macros while at the same time adding uniformity in measures of comorbid conditions and other covariates. The data product was tested in a project on statin effectiveness in older patients with multiple comorbidities. Results: A programmer/analyst with no administrative claims data experience was able to use the data product to create an analytic dataset with minimal support aside from the documentation provided. Analytic dataset creation used the conditions, procedures, and timeline macros provided. The data structure created for AMI adapted successfully for stroke. Complexity increased and statin treatment decreased with age. The two-year survival benefit of statins post-AMI increased with age. Conclusion: Claims data can be made more user-friendly for CER research on complex conditions. The data product should be expanded by refreshing the cohort and increasing follow-up. Action is warranted to increase the rate of statin use among the oldest patients. Data Access: These data are not available from ICPSR. The data cannot be made publicly available. Data are stored on University of Iowa College of Public Health secure servers, and may be used only for projects covered within the aims of the original research protocol and Centers for Medicare and Medicaid Services (CMS)-approved data use agreement. Data sharing is allowed only for research protocols approved under data re-use requests by the CMS privacy board. The CMS process for data re-use requests is described at Research Data Assistance Center (ResDac). Please note that as of May 2013, the DUA covering this work is set to expire February 1, 2014. Thereafter, per the terms of the DUA, datasets created for this project may not be available. User guides are available from ICPSR for detailed descriptions of the data products, including a user guide for Acute Myocardial Infarction (AMI) Analytic Files and a user guide for Stroke and Transient Ischemic Attack (TIA) Analytic Files. Data dictionaries are available upon request. Please contact Nick Rudzianski (nicholas-rudzianski@uiowa.edu or 319-335-9783) for more information.