Medicare Claims Reveal Flaws in Self-Reports of Rheumatoid Arthritis

Most patients who self-report a physician diagnosis of rheumatoid arthritis (RA) do not have a Medicare claims history to validate the diagnosis, researchers reported.

The investigators reviewed the responses of 3768 participants in the United States Health and Retirement Study in 2004, 2008, and 2012, both with and without incident self‐reported RA. A total of 345 respondents self-reported that they had been diagnosed with RA by a physician. The positive predictive value (PPV) of self‐report ranged from 0.05 to 0.16., with a sensitivity range from 0.23 to 0.55.; and the κ statistic ranging from 0.07 to 0.15 across 3 RA algorithms: a single claim for RA under International Classification of Diseases, ninth edition, Clinical Modification; 2 or more claims no more than 2 years apart; and 2 or more claims with at least 1 diagnosis of RA by a rheumatologist.

The researchers questioned whether additional survey questions are needed to determine whether older patients who are taking medication for RA, and who have seen a physician in the past 2 years for arthritis treatment, can improve the PPV and other measures of the validity of self‐reported RA.

“Additional self‐report data regarding arthritis care improved the PPV and other validity measures of self‐report; however, the values remained low,” the authors concluded. “Revisions to current self‐reported RA questions in older adults may yield clear, and more valid, identification of RA in national health surveys.”



-Angelique Platas

Reference:

Booth MJ, Clauw D,  Janevic MR. Validation of self‐reported rheumatoid arthritis using Medicare claims: A nationally representative longitudinal study of older adults. ACR Open Rheumatol. Published online February 23, 2021. http://doi.org/10.1002/acr2.11229