Abstract Details

Title Enhancing Case Ascertainment of Parkinson's Disease Using Medicare Claims Data in a Population-Based Cohort: The Cardiovascular Health Study

Topic Movement Disorders

Presentation(s) P03 - (-)

Poster/Presentation
Number 065

Objective

Background BACKGROUND: Cohort studies such as the CHS with extensive longitudinal measures among older adults provide opportunities to address efficiently hypotheses for rare diseases, including PD. Because clinical evaluations for PD were not performed in the CHS, other sources of information must be used. Our original case ascertainment used a combination of self-reported PD diagnosis, anti-parkinsonian medication assessed annually, and hospitalization discharge ICD-9 code. Outpatient billing claims from Medicare provide important information that may enhance ascertainment of PD.

Design/Methods DESIGN/METHODS: We incorporated additional data sources from fee-for-service Medicare claims, extended follow-up time, review of medical records, and adjudicated cause of death. Two movement disorders specialists reviewed all data and adjudicated final PD status. We used logistic regression models and controlled for age, sex, and African American race.

Results RESULTS: The enhanced ascertainment method identified 75 additional cases, but also reclassified 80 previously identified cases as not having PD. We observed significant inverse association with smoking status (odds ratio=0.41; 95% confidence interval=0.21, 0.80), and inverse linear trends with years since quitting (p=0.005), pack-years (p=0.005), and cigarettes per day (p=0.017), all of which were stronger than estimates from the previous algorithm.

Conclusions CONCLUSIONS: Although our enhanced method identified a number of new PD cases, and reclassified findings did not appreciably alter prevalence and incidence estimates compared to our previous algorithm. However, our enhanced method provided stronger estimates of association, potentially due to a reduced level of disease misclassification.

Authors/Disclosures
Thanh Ton, PhD (Precision Health Economics) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Macaulay Okwuokenye	No disclosure on file
Shu-Ching Hu, MD (University of Washington)	No disclosure on file
Evan Thacker, PhD (Brigham Young University)	The institution of Evan Thacker, PhD has received research support from NIH.
Susan Searles Nielsen	No disclosure on file
	No disclosure on file
	No disclosure on file
W. T. Longstreth, Jr., MD, FAAN (Harborview Medical Center)	The institution of Dr. Longstreth has received research support from NIH.
	No disclosure on file
Samay Jain, MD (University of Pittsburgh Medical Center)	No disclosure on file

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