title: Assessing asthma severity based on claims data: a systematic review.
abstract: BACKGROUND
  Asthma is one of the most common chronic diseases in Germany. Substantial economic evaluation of asthma cost requires knowledge of asthma severity, which is in general not part of claims data. Algorithms need to be defined to use this data source.
  
  
  OBJECTIVE
  The aim of this study was to systematically review the international literature to identify algorithms for the stratification of asthma patients according to disease severity based on available information in claims data.
  
  
  METHODS
  A systematic literature review was conducted in September 2015 using the DIMDI SmartSearch, a meta search engine including several databases with a national and international scope, e.g. BIOSIS, MEDLINE, and EMBASE. Claims data based studies that categorize asthma patients according to their disease severity were identified.
  
  
  RESULTS
  The systematic research yielded 54 publications assessing asthma severity based on claims data. Thirty-nine studies used a standardized algorithm such as HEDIS, Leidy, the GINA based approach or CACQ. Sixteen publications applied a variety of different criteria for the severity categorisation such as asthma diagnoses, asthma-related drug prescriptions, emergency department visits, and hospitalisations.
  
  
  CONCLUSIONS
  There is no best practice method for the categorisation of asthma severity with claims data. Rather, a combination of algorithms seems to be a pragmatic approach. A transfer to the German context is not entirely possible without considering particular conditions associated with German claims data.
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany. Christian.Jacob@xcenda.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Jacob
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Haas
authors.affiliation: GlaxoSmithKline, Uxbridge, Greater London, UK.
authors.forename: Benno
authors.initials: B
authors.lastname: Bechtel
authors.affiliation: Group Practice and Centre for Pneumology, Allergy and Sleep Medicine at Red Cross Maingau Hospital, Frankfurt am Main, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kardos
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Braun
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D002908:Chronic Disease; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D012720:Severity of Illness Index
keywords: Asthma; Claims data; Economic evaluation; Exacerbation; GINA; HEDIS; Intermittent; Leidy; Persistent; Systematic review