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BMC Health Services Research

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Open Access 01-12-2016 | Research article

Validity of a stroke severity index for administrative claims data research: a retrospective cohort study

Authors: Sheng-Feng Sung, Cheng-Yang Hsieh, Huey-Juan Lin, Yu-Wei Chen, Chih-Hung Chen, Yea-Huei Kao Yang, Ya-Han Hu

Published in: BMC Health Services Research | Issue 1/2016

Abstract

Background

Ascertaining stroke severity in claims data-based studies is difficult because clinical information is unavailable. We assessed the predictive validity of a claims-based stroke severity index (SSI) and determined whether it improves case-mix adjustment.

Methods

We analyzed patients with acute ischemic stroke (AIS) from hospital-based stroke registries linked with a nationwide claims database. We estimated the SSI according to patient claims data. Actual stroke severity measured with the National Institutes of Health Stroke Scale (NIHSS) and functional outcomes measured with the modified Rankin Scale (mRS) were retrieved from stroke registries. Predictive validity was tested by correlating SSI with mRS. Logistic regression models were used to predict mortality.

Results

The SSI correlated with mRS at 3 months (Spearman rho = 0.578; 95 % confidence interval [CI], 0.556–0.600), 6 months (rho = 0.551; 95 % CI, 0.528–0.574), and 1 year (rho = 0.532; 95 % CI 0.504–0.560). Mortality models with the SSI demonstrated superior discrimination to those without. The AUCs of models including the SSI and models with the NIHSS did not differ significantly.

Conclusions

The SSI correlated with functional outcomes after AIS and improved the case-mix adjustment of mortality models. It can act as a valid proxy for stroke severity in claims data-based studies.

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Title: Validity of a stroke severity index for administrative claims data research: a retrospective cohort study
Authors: Sheng-Feng Sung
Cheng-Yang Hsieh
Huey-Juan Lin
Yu-Wei Chen
Chih-Hung Chen
Yea-Huei Kao Yang
Ya-Han Hu
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-016-1769-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Validity of a stroke severity index for administrative claims data research: a retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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