Comprehensive Codified Algorithms to Identify the Underestimated Burden of Hidradenitis Suppurativa in the United States.

IF 3.5 3区医学 Q1 DERMATOLOGY

Dermatology and Therapy Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI:10.1007/s13555-024-01259-0

John R Ingram, Yvonne Geissbühler, John Darcy, Stephen Foley, Alex Gaffney, Aine McConnon, Craig Richardson, Amit Garg

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Abstract

Introduction: Hidradenitis suppurativa (HS) is a painful, inflammatory skin disease associated with a high disease burden and long diagnostic delay. Prevalence estimates of HS vary widely in the literature owing to differing estimation methodologies. This study aimed to apply stepwise algorithms to estimate the prevalence of possible/diagnosed cases of HS in the US.

Methods: This was a retrospective cohort study in adult and pediatric patients with HS which utilized data from four US databases (MarketScan [Medicare and Medicaid] and Optum [electronic health record (EHR) and Clinformatics Data Mart (CDM)]). Patients with possible/diagnosed HS were identified using two algorithms (termed Algorithm 1 and Algorithm 2), which assessed symptoms such as multiple skin boils in site-specific areas based on international classification of disease (ICD) codes. Patients with diagnosed HS were defined as having ≥ 2 outpatient or ≥ 1 inpatient diagnosis codes of HS. In each database, patients with continuous medical and pharmacy benefits in the 365 days pre-index and 0-365 days post-index periods were eligible for inclusion.

Results: Across all databases, Algorithm 2 (MarketScan Medicare [N = 309,916]; MarketScan Medicaid [N = 188,783]; Optum EHR [N = 366,158]; Optum CDM [N = 173,812]) identified more patients with possible/diagnosed HS than Algorithm 1 (MarketScan Medicare [N = 194,353]; MarketScan Medicaid [N = 99,276]; Optum EHR [N = 177,957]; Optum CDM [N = 112,244]). Based on ICD-9/10 codes, the 5-year period prevalence of HS ranged from 0.06% to 0.12% across all databases, while for Algorithm 1 and Algorithm 2, this ranged from 0.27% to 0.41% and 0.49% to 0.78%, respectively. Adults and females generally had a higher 5-year period prevalence versus pediatric patients and males, respectively.

Conclusion: This real-world study highlights that HS diagnosis codes alone may be insufficient to estimate the prevalence of HS, demonstrating the value of employing algorithms in practice which assess for parameters such as multiple skin boils in site-specific areas. Integrating robust methods to identify the prevalence of HS may improve the diagnostic delay observed in HS and improve treatment outcomes.

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综合编纂算法，确定美国被低估的化脓性扁桃体炎负担。

简介化脓性扁平湿疹（HS）是一种疼痛的炎症性皮肤病，疾病负担重，诊断时间长。由于估算方法不同，文献中对化脓性扁平湿疹患病率的估算也大相径庭。本研究旨在应用逐步算法估算美国 HS 可能/确诊病例的患病率：这是一项针对成人和儿童 HS 患者的回顾性队列研究，利用了美国四个数据库（MarketScan [医疗保险和医疗补助] 和 Optum [电子健康记录 (EHR) 和 Clinformatics Data Mart (CDM)]）中的数据。使用两种算法（称为算法 1 和算法 2）确定可能/确诊为 HS 的患者，这两种算法根据国际疾病分类 (ICD) 代码评估特定部位的多发性皮肤疖等症状。确诊为 HS 的患者定义为门诊患者中 HS 诊断代码≥2 个或住院患者中 HS 诊断代码≥1 个。在每个数据库中，在指数发布前的 365 天和指数发布后的 0-365 天内连续享受医疗和药房福利的患者均符合纳入条件：在所有数据库中，算法 2（MarketScan Medicare [N = 309,916]; MarketScan Medicaid [N = 188,783]; Optum EHR [N = 366,158]；Optum CDM [N = 173,812]) 相比算法 1（MarketScan Medicare [N = 194,353]; MarketScan Medicaid [N = 99,276]; Optum EHR [N = 177,957]; Optum CDM [N = 112,244]）识别出更多可能/确诊为 HS 的患者。根据 ICD-9/10 编码，所有数据库的 5 年期 HS 患病率介于 0.06% 到 0.12% 之间，而算法 1 和算法 2 的患病率分别介于 0.27% 到 0.41% 和 0.49% 到 0.78% 之间。与儿科患者和男性相比，成人和女性的 5 年患病率普遍较高：这项真实世界的研究强调，仅凭HS诊断代码可能不足以估算HS的患病率，这表明在实践中采用算法评估特定部位多发皮肤疖等参数的价值。整合可靠的方法来确定HS的患病率，可以改善HS的诊断延迟并提高治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.