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Abstract Details

Identification of Patients with Incident Parkinson Disease Using ICD-10-CM Codes in Claims Data
General Neurology
P8 - Poster Session 8 (8:00 AM-9:00 AM)
11-014
To develop a model using administrative claims data to predict Parkinson disease (PD) risk.
We previously used Current Procedural Terminology (CPT) and ICD-9-CM codes from 2004-2009 Medicare data to build a predictive model to identify incident PD patients in 2009. While the model performed well with an area under the receiver operating characteristic curve (AUC) of 0.86, the conversion from ICD-9-CM to ICD-10-CM in the U.S. requires that this be redeveloped with ICD-10-CM codes.
Among beneficiaries age-eligible for Medicare, we used 2014-2018 Medicare data to identify all incident PD patients in 2018 (N=93,238) and 1:4 frequency matched with controls (N=372,952) on year and month of diagnosis. We created predictor variables for demographics (age, sex, race/ethnicity, and smoking), all ICD-10-CM diagnosis codes that occurred from October 2015, and all procedure codes (CPT, Healthcare Common Procedure Coding System, and ICD-10 procedure codes) from 2014 to the beneficiary diagnosis or reference date. We randomly divided the dataset into 80% training and 20% validation, then used elastic net algorithm to determine which ICD-10-CM and procedure codes best predicted a PD case. With the training data, we used a five-fold cross validation to select the two hyper-parameters (alpha and lambda), and the predictive accuracy of the model was evaluated using AUC and 95% confidence intervals (CIs). We also performed tests for multicollinearity and removed collinear variables and sex-specific codes.
Using only demographic variables, the AUC was 0.659 (95% CI: 0.657-0.661). In our elastic net model with diagnosis and procedure codes, the best alpha was 0.5 with 481 predictors, resulting in an AUC in the validation set of 0.871 (95% CI: 0.868-0.874).

A predictive model of incident PD patients using Medicare data with ICD-10-CM and procedure codes performs substantially better than a simple, demographics-based model and is comparable to our ICD-9-CM model.
Authors/Disclosures
Jordan A. Killion, PhD (Barrow Neurological Institute)
PRESENTER 		Dr. Killion has received personal compensation for serving as an employee of CommonSpirit Health. The institution of Dr. Killion has received research support from The Michael J. Fox Foundation for Parkinson's Research (MJFF-000939). The institution of Dr. Killion has received research support from Department of Defense Grant (PD190057). The institution of Dr. Killion has received research support from Barrow Neurological Foundation. The institution of Dr. Killion has received research support from Kemper and Ethel Marley Foundation. The institution of Dr. Killion has received research support from Moreno Family.
Susan Nielsen (Washington University in St. Louis) The institution of Susan Nielsen has received research support from National Institutes of Health. The institution of Susan Nielsen has received research support from Department of Defense. The institution of Susan Nielsen has received research support from The Michael J. Fox Foundation for Parkinson's Research. The institution of Susan Nielsen has received research support from Cure Alzheimer's. Susan Nielsen has received personal compensation in the range of $0-$499 for serving as a Panel/committee member with The Michael J. Fox Foundation for Parkinson's Research. Susan Nielsen has received personal compensation in the range of $0-$499 for serving as a Reviewer with Parkinson's Disease Foundation.
Kassu Mehari Beyene, PhD Dr. Beyene has nothing to disclose.
Irene Faust, MPH (Barrow Neurological Institute) Ms. Faust has nothing to disclose.
ALEJANDRA CAMACHOSOTO, MD The institution of Dr. CAMACHOSOTO has received research support from Michael J Fox Foundation . The institution of Dr. CAMACHOSOTO has received research support from NIH NCATS KL2 Career Development.
Susan Criswell, MD (Washington University) Dr. Criswell has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie.
Brad A. Racette, MD, FAAN (Barrow Neurological Institute) Dr. Racette has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for American Regent. Dr. Racette has received personal compensation in the range of $500-$4,999 for serving as a advisory council with NIEHS.