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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Pharmacoepidemiology...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Pharmacoepidemiology and Drug Safety
Article . 2025 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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Comparing Two Approaches to Identify Individuals with Severe Asthma in United States Claims Data

Authors: Julie, Barberio; Xinyu, Li; Sarah-Jo, Sinnott;

Comparing Two Approaches to Identify Individuals with Severe Asthma in United States Claims Data

Abstract

ABSTRACT Purpose Given the increased likelihood for individuals with severe asthma to experience comorbidities, disease complications, emergency room visits, and hospitalizations, the ability to stratify asthma populations on severity is often important. Although pharmacoepidemiologic studies using administrative healthcare databases sometimes categorize asthma severity, there is no consensus on an approach. Methods Individuals with asthma (≥ 2 ICD‐10‐CM diagnosis codes J45) aged ≥ 6 years were identified in Optum's de‐identified Clinformatics Data Mart Database between January 2017 and November 2023. Severe asthma was inferred, consistent with the Global Initiative for Asthma (GINA), from prescription claims for high‐dose inhaled corticosteroids (ICS) in combination with long‐acting beta‐agonists (LABA) (Step 5 treatment). Two algorithm versions were employed to isolate the impact of dose estimation methods: (1) the “code‐based method” considered high‐dose ICS‐LABA to be an inhaler property and defined severe asthma based on claims for ICS‐LABA from our pre‐determined list; (2) the “calculation‐based method” considered high‐dose ICS‐LABA to be a regimen property and defined severe asthma based on derived patient‐level average daily dose. Results A total of 1 221 732 individuals with asthma were identified, 3.1% of which were severe by the code‐based method and 4.2% by the calculation‐based method. Both methods appeared to be consistent with the benchmark cited by GINA (3.7%). No meaningful differences were observed in the characteristics of the cohorts. 27% of calculation‐based individuals with severe asthma were not captured by the code‐based method. Conclusions Estimating patient‐level average daily ICS dose based on prescription claims using either a code‐based or a calculation‐based algorithm appears to be a reasonable method to identify individuals with severe asthma. The discrepancy between methods suggests that physician instructions sometimes vary from recommended administration instructions. Future work will validate these algorithms using electronic medical records.

Related Organizations
Keywords

Male, Adult, Databases, Factual, Adolescent, Pharmacoepidemiology, Middle Aged, Severity of Illness Index, Asthma, United States, Young Adult, Adrenal Cortex Hormones, Administration, Inhalation, Humans, Female, Anti-Asthmatic Agents, Child, Algorithms, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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