On Data Sets, Extrapolations, and Urologic Issues

Abstract

There is an increasing use of large data groupings extracted from administrative claims sets to extrapolate trends of syndrome and disease diagnosis, treatment, and outcome for populations from which these data sets are acquired. One of the most extensive assessments using administrative claims is the Urologic Diseases in America project, an ongoing analysis of urologic diseases and syndromes in the United States that uses data sets acquired from three main areas: the US government (Medicare), unique sources representative of national health care utilization and expense data (eg, the Healthcare Cost and Utilization Project–Nationwide Inpatient Sample and the Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey), and special data sets for specific conditions and subpopulations (National Nursing Home Survey and the Veterans Health Administration National Surgical Quality Improvement Project) [1]. The explicit inclusion of multiple differing data sources and the longitudinal acquisition, compilation, and interpretation of data from these sources represents one of the most impressive efforts to date in the use of large administrative data sets to aggregate important knowledge previously disparate and often under- or unappreciated. In this month’s journal, a compilation of administrative claims sets are assayed for the use of a particular medication type within a population with conclusions rendered about gender-based differences in recognition and therapy [2]. The patient data set was derived for a 1-yr period with administrative claims from >85 US health care plans and included 9 991 730 patients from all age groups. The goal of the study was to determine frequencies of medical (pharmacologic) treatment for overactive bladder (OAB) symptoms in both men and women. Diagnostic codes from the International Classification of Diseases, specifically diagnostic codes for OAB (596.xx and 788.3x), were used to identify those who were candidates for therapy (and were 45 yr of age). These individuals were then linked to prescription drug data for the population. OAB medication use (which was defined as either an anticholinergic and/or tricyclic class of agent) was derived from the prescription drug data. Individuals who received medication during the study time frame were considered treated; those who did not were considered untreated. Gender-specific and -nonspecific comorbidities were also identified. The authors concluded that men received treatment for symptoms of OAB less frequently than women, regardless of age.