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Fracture definitions in observational osteoporosis drug effects studies that leverage healthcare administrative (claims) data: a scoping review.
- Source :
- Osteoporosis International; Sep2022, Vol. 33 Issue 9, p1837-1844, 8p, 1 Diagram, 2 Charts
- Publication Year :
- 2022
-
Abstract
- Summary: Healthcare administrative (claims) data are commonly utilized to estimate drug effects. We identified considerable heterogeneity in fracture outcome definitions in a scoping review of 57 studies that estimated osteoporosis drug effects on fracture risk. Better understanding of the impact of different fracture definitions on study results is needed. Purpose: Healthcare administrative (claims) data are frequently used to estimate the real-world effects of drugs. Fracture incidence is a common outcome of osteoporosis drug studies. We aimed to describe how fractures are defined in studies that use claims data. Methods: We searched MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), and gray literature for studies published in English between 2000 and 2020 that estimated fracture effectiveness (hip, humerus, radius/ulna, vertebra) or safety (atypical fracture of the femur, AFF) of osteoporosis drugs using claims data in Canada and the USA. Literature searches, screening and data abstraction were completed independently by two reviewers. Results: We identified 57 eligible studies (52 effectiveness, 3 safety, 2 both). Hip fracture was the most common fracture site studied (93%), followed by humerus (66%), radius/ulna (59%), vertebra (61%), and AFF (9%). Half (n = 29) of the studies did not indicate specific data sources, codes, or cite a validation paper. Of the papers with sufficient detail, heterogeneity in fracture definitions was common. The most common definition within each fracture site was used by less than half of the studies that examined effectiveness (12 definitions in 29 hip fracture papers, 8 definitions in 17 humerus papers, 8 definitions in 13 radius/ulna papers, 9 definitions in 15 vertebra papers), and 3 definitions among 4 AFF papers. Conclusion: There is ambiguity and heterogeneity in fracture outcome definitions in studies that leverage claims data. Better transparency in outcome reporting is needed. Future exploration of how fracture definitions impact study results is warranted. [ABSTRACT FROM AUTHOR]
- Subjects :
- EVALUATION of medical care
CINAHL database
DIPHOSPHONATES
MEDICAL information storage & retrieval systems
SYSTEMATIC reviews
HIP fractures
ULNA injuries
HEALTH insurance reimbursement
OSTEOPOROSIS
HUMERUS
LITERATURE reviews
MEDLINE
BONE fractures
RADIUS fractures
VERTEBRAL fractures
FEMORAL fractures
Subjects
Details
- Language :
- English
- ISSN :
- 0937941X
- Volume :
- 33
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Osteoporosis International
- Publication Type :
- Academic Journal
- Accession number :
- 159003381
- Full Text :
- https://doi.org/10.1007/s00198-022-06395-x