Does a claims diagnosis of autism mean a true case?

James P. Burke, Anjali Jain, Wenya Yang, Jonathan P. Kelly, Marygrace Kaiser, Laura Becker, Lindsay Lawer, Craig J. Newschaffer

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)321-330
Number of pages10
JournalAutism
Volume18
Issue number3
DOIs
StatePublished - Apr 2014

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology

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