Characterization of SARS-CoV-2 Diagnostic Tests and Liver Function Tests Among Patients With COVID-19 Diagnosed in Outpatient Settings Using Administrative Healthcare Data and Data From Commercial Laboratories.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-01-01 DOI:10.1002/pds.70094

Ayad K Ali, Aidan Baglivo, Priya Govil, Liza R Gibbs, Marie C Bradley, Keith E Campbell, Aloka Chakravarty, Tamar Lasky, Victoria Derbyshire, Elizabeth M Garry

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引用次数: 0

Abstract

Purpose: To characterize select laboratory tests ordered versus reported for patients diagnosed with COVID-19 in administrative healthcare and commercial laboratory data.

Methods: Among patients with an outpatient COVID-19 diagnosis claim in HealthVerity data (01/01/2021-12/31/2022), this study described baseline characteristics and descriptively compared SARS-CoV-2 diagnostic tests and liver function tests from administrative healthcare (insurance claims and hospital billing data) and commercial laboratories, overall and by code type (e.g., CPT, LOINC). Select liver function tests were also described by method-specific and methodless LOINC.

Results: Among 214 998 patients with COVID-19, 46.1% had a SARS-CoV-2 molecular diagnostic test recorded within 7 days of diagnosis (in either administrative or laboratory data); 44.5% had a corresponding CPT in medical claims, while only 10.0% had a corresponding LOINC in laboratory data. In contrast, the six most common liver function tests (albumin, aspartate aminotransferase, total protein, alkaline phosphatase, alanine aminotransferase, and total bilirubin) were identified in 55.7%-56.6% of patients via LOINC, but only in 3.2%-4.2% via CPT claims. Of the total count of select liver function tests performed in the laboratory data, 99.7% of aspartate aminotransferase, 96.1% of direct bilirubin, and 82.9% of lactate dehydrogenase were reported by methodless LOINC rather than method-specific LOINC.

Conclusions: Important differences were identified between orders for SARS-CoV-2 diagnostic tests and liver function tests, as well as missingness of LOINC method, highlighting challenges related to completeness of laboratory data in real-world data sources. These challenges underscore a need to improve data quality when considering the utility of laboratory data for research.

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利用行政保健数据和商业实验室数据对门诊诊断的COVID-19患者的SARS-CoV-2诊断测试和肝功能测试的特征

目的：在行政卫生保健和商业实验室数据中，对COVID-19诊断患者订购的和报告的选择实验室检测进行表征。方法：在HealthVerity数据（2021年1月1日至2022年12月31日）中门诊COVID-19诊断索赔的患者中，本研究描述了基线特征，并描述性地比较了行政医疗保健（保险索赔和医院账单数据）和商业实验室的SARS-CoV-2诊断检测和肝功能检测，总体上并按代码类型（例如CPT， LOINC）进行了比较。选择肝功能试验也描述了方法特异性和无方法LOINC。结果：在214 998例COVID-19患者中，46.1%的患者在诊断后7天内记录了SARS-CoV-2分子诊断检测（无论是行政数据还是实验室数据）；44.5%的医疗索赔中有相应的CPT，而只有10.0%的实验室数据中有相应的LOINC。相比之下，6项最常见的肝功能检查（白蛋白、天冬氨酸转氨酶、总蛋白、碱性磷酸酶、丙氨酸转氨酶和总胆红素）通过LOINC在55.7%-56.6%的患者中被识别出来，但通过CPT的患者中只有3.2%-4.2%被识别出来。在实验室数据中进行的选择肝功能检查的总计数中，99.7%的天冬氨酸转氨酶、96.1%的直接胆红素和82.9%的乳酸脱氢酶是用无方法LOINC报告的，而不是用方法特异性LOINC报告的。结论：在SARS-CoV-2诊断检测订单和肝功能检测订单之间存在重要差异，以及LOINC方法的缺失，突出了与真实数据源中实验室数据完整性相关的挑战。这些挑战强调了在考虑实验室数据用于研究时提高数据质量的必要性。

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

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.