PMID- 28837450
OWN - NLM
STAT- MEDLINE
DCOM- 20190910
LR  - 20190910
IS  - 1945-1474 (Electronic)
IS  - 1062-2551 (Linking)
VI  - 40
IP  - 2
DP  - 2018 Mar/Apr
TI  - Identifying Persistent Asthma in Children: A Comparison of Healthcare 
      Effectiveness Data and Information Set Criteria and National Heart, Lung, and 
      Blood Institute Guidelines.
PG  - e20-e25
LID - 10.1097/JHQ.0000000000000098 [doi]
AB  - Persistent asthma requires a daily controller medication. National Heart, Lung, 
      and Blood Institute (NHLBI) guidelines and Healthcare Effectiveness Data and 
      Information Set (HEDIS) quality measures are used to identify persistent asthma, 
      the former method used by clinicians, and the latter by managed care 
      organizations (MCOs). This study aims to determine the degree of agreement 
      between these criteria in classifying pediatric persistent asthma. Asthmatic 
      patients aged 5-18 years old in a university pediatric practice who were 
      continuously enrolled with one MCO from January 1, 2012 to December 31, 2013 
      (Cohort 1: 329 patients) and January 1, 2013 to December 31, 2014 (Cohort 2: 212 
      patients) were identified. Subjects with at least one asthma visit were included. 
      Independence of NHLBI and HEDIS criteria was determined by the McNemar test. 
      Agreement was determined by confusion matrix analysis and Cohen kappa statistic 
      with continuity correction. Agreement in controller assignment was 82% in Cohort 
      1 and 88% in Cohort 2. Agreement was fair in Cohort 1 (Cohen kappa = 0.364; 95% 
      confidence interval [CI] = 0.217-0.511) and moderate in Cohort 2 (Cohen kappa = 
      0.447; 95% CI = 0.247-0.646). The HEDIS misclassified persistent asthma by 16.4% 
      (95% CI: 11.5-21.2%) and 11.8% (95% CI: 6.8-16.7%) in Cohorts 1 and 2, 
      respectively. NHLBI and HEDIS criteria show fair to moderate agreement; however, 
      the HEDIS consistently misclassified persistent asthma, suggesting that it is a 
      poor measure of practice performance.
FAU - Hall, Ashleigh
AU  - Hall A
FAU - Smolij, Carol
AU  - Smolij C
FAU - Moughan, Beth
AU  - Moughan B
FAU - Kechli, Amer
AU  - Kechli A
FAU - Aronoff, Stephen
AU  - Aronoff S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Healthc Qual
JT  - Journal for healthcare quality : official publication of the National Association 
      for Healthcare Quality
JID - 9202994
RN  - 0 (Anti-Asthmatic Agents)
MH  - Adolescent
MH  - Anti-Asthmatic Agents/*economics/*standards/therapeutic use
MH  - Asthma/*drug therapy/*economics/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Female
MH  - Guideline Adherence/*statistics & numerical data
MH  - *Guidelines as Topic
MH  - Humans
MH  - Male
MH  - Managed Care Programs/*economics/*statistics & numerical data
MH  - National Heart, Lung, and Blood Institute (U.S.)
MH  - United States/epidemiology
EDAT- 2017/08/25 06:00
MHDA- 2019/09/11 06:00
CRDT- 2017/08/25 06:00
PHST- 2017/08/25 06:00 [pubmed]
PHST- 2019/09/11 06:00 [medline]
PHST- 2017/08/25 06:00 [entrez]
AID - 10.1097/JHQ.0000000000000098 [doi]
PST - ppublish
SO  - J Healthc Qual. 2018 Mar/Apr;40(2):e20-e25. doi: 10.1097/JHQ.0000000000000098.