Administrative data used to identify patients with irritable bowel syndrome.
OBJECTIVE
To assess the usefulness of health plan administrative data for identifying patients with irritable bowel syndrome (IBS).


METHODS
In this retrospective study of 442 medical records of patients in nine U.S. health plans, five sets of criteria that used administrative data were used to identify potential IBS patients. Physician reviewers provided an assessment of the likelihood of the diagnosis of IBS being present. IBS was considered to be present if the physician reviewer categorized the case as definite, probable, or possible based on medical record review. Analyses were also performed with cases categorized as possible placed in an "IBS not present" category.


RESULTS
The positive predictive value (PPV) for the five sets of criteria ranged from 63% to 83% with the highest PPV found with one of the most restrictive criteria. When cases characterized as possible were included in the "IBS not present" category, the PPV for each of the five sets of criteria decreased substantially, ranging from 33% to 63%.


CONCLUSIONS
The PPV of different criteria used to identify patients with IBS from administrative data varies substantially based on the criteria that are used. Use of criteria with a higher PPV may come at the expense of generalizability.
Goff
Sarah L
SL
Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Clinic Foundation and Fallon Community Health Plan, 630 Plantation Street, Worcester, MA 01605, USA.
Feld
Andrew
A
Andrade
Susan E
SE
Mahoney
Lisa
L
Beaton
Sarah J
SJ
Boudreau
Denise M
DM
Davis
Robert L
RL
Goodman
Michael
M
Hartsfield
Cynthia L
CL
Platt
Richard
R
Roblin
Douglas
D
Smith
David
D
Yood
Marianne Ulcickas
MU
Dodd
Katherine
K
Gurwitz
Jerry H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology