@article{3bdb95c3ffec4225bbcd40d75dd30ee1,
title = "Development of a claims-based algorithm to identify potentially undiagnosed chronic migraine patients",
abstract = "Objective: To develop a claims-based algorithm to identify undiagnosed chronic migraine among patients enrolled in a healthcare system. Methods: An observational study using claims and patient survey data was conducted in a large medical group. Eligible patients had an International Classification of Diseases, Ninth/Tenth Revision (ICD-9/10) migraine diagnosis, without a chronic migraine diagnosis, in the 12 months before screening and did not have a migraine-related onabotulinumtoxinA claim in the 12 months before enrollment. Trained clinicians administered a semi-structured diagnostic interview, which served as the gold standard to diagnose chronic migraine, to enrolled patients. Potential claims-based predictors of chronic migraine that differentiated semi-structured diagnostic interview-positive (chronic migraine) and semi-structured diagnostic interview-negative (non-chronic migraine) patients were identified in bivariate analyses for inclusion in a logistic regression model. Results: The final sample included 108 patients (chronic migraine = 64; non-chronic migraine = 44). Four significant predictors for chronic migraine were identified using claims in the 12 months before enrollment: ≥15 versus <15 claims for acute treatment of migraine, including opioids (odds ratio = 5.87 [95% confidence interval: 1.34–25.63]); ≥24 versus <24 healthcare visits (odds ratio = 2.80 [confidence interval: 1.08–7.25]); female versus male sex (odds ratio = 9.17 [confidence interval: 1.26–66.50); claims for ≥2 versus 0 unique migraine preventive classes (odds ratio = 4.39 [confidence interval: 1.19–16.22]). Model sensitivity was 78.1%; specificity was 72.7%. Conclusions: The claims-based algorithm identified undiagnosed chronic migraine with sufficient sensitivity and specificity to have potential utility as a chronic migraine case-finding tool using health claims data. Research to further validate the algorithm is recommended.",
keywords = "Chronic migraine, case-finding tool, diagnosis predictors, health claims data",
author = "Pavlovic, {Jelena M.} and Yu, {Justin S.} and Silberstein, {Stephen D.} and Reed, {Michael L.} and Kawahara, {Steve H.} and Cowan, {Robert P.} and Firas Dabbous and Campbell, {Karen L.} and Shewale, {Anand R.} and Riya Pulicharam and Kowalski, {Jonathan W.} and Viswanathan, {Hema N.} and Lipton, {Richard B.}",
note = "Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this study was provided by Allergan plc (Dublin, Ireland). Funding Information: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Jelena M Pavlovic has served as a consultant and/or advisory panel member for Alder Biopharmaceuticals, Allergan, and Dr Reddy{\textquoteright}s Laboratories, and has received travel support from the American Headache Society and North American Menopause Society. She has received research support from the NIH/NIA. Justin S Yu is a former employee of Allergan plc and owns stock in the company. Stephen D Silberstein has served as a consultant and/or advisory panel member for Alder Biopharmaceuticals, Allergan Inc, Amgen, Avanir Pharmaceuticals Inc, eNeura, ElectroCore Medical, LLC, Dr Reddy{\textquoteright}s Laboratories, Medscape, LLC, NINDS, Teva Pharmaceuticals, Supernus Pharmaceuticals Inc, and Theranica. His employer receives research support from Allergan Inc, Amgen, Dr Reddy{\textquoteright}s Laboratories, ElectroCore Medical Inc, Eli Lilly and Company, and Supernus Pharmaceuticals. Michael L Reed is Managing Director of Vedanta Research, which has received research funding from Allergan, Amgen, Dr Reddy{\textquoteright}s Laboratories, Eli Lilly, GlaxoSmithKline, Merck & Co., Inc., and Promius, via grants to the National Headache Foundation. Steve Kawahara and Riya Pulicharam are full-time employees of DaVita Medical Group. Robert P Cowan and Firas Dabbous have no financial disclosures to report. Karen Campbell, Anand R Shewale and Jonathan Kowalski are full-time employees of Allergan plc and own stock in the company. Hema N Viswanathan is an employee of Allergan plc and holds stock or stock options, patents, or other intellectual property. Richard B Lipton serves on the editorial boards of Neurology and Cephalalgia and as senior advisor to Headache. He has received research support from the NIH. He also receives support from the Migraine Research Foundation and the National Headache Foundation. He has reviewed for the NIA and NINDS; serves as consultant, advisory board member, or has received honoraria from Alder, Allergan, Amgen, Autonomic Technologies, Avanir, Biohaven, Biovision, Boston Scientific, Dr Reddy{\textquoteright}s, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmithKline, Merck, Novartis, Pernix, Pfizer, Supernus, Teva, Vector, and Vedanta. He receives royalties from Wolff{\textquoteright}s Headache (8th Edition, Oxford University Press), Informa, and Wiley. He holds stock options in eNeura Therapeutics and Biohaven. Funding Information: Editorial support for development of this manuscript was provided by Lee B Hohaia, at Complete Healthcare Communications, LLC (West Chester, PA), a CHC Group company, and funded by Allergan plc (Dublin, Ireland). Publisher Copyright: {\textcopyright} International Headache Society 2019.",
year = "2019",
month = apr,
day = "1",
doi = "10.1177/0333102418825373",
language = "English (US)",
volume = "39",
pages = "465--476",
journal = "Cephalalgia",
issn = "0333-1024",
publisher = "SAGE Publications Ltd",
number = "4",
}