{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T19:13:49Z","timestamp":1791054829379,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30 AR072583"],"award-info":[{"award-number":["P30 AR072583"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K23 AR073931\u201001"],"award-info":[{"award-number":["K23 AR073931\u201001"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess accuracy of administrative claims prescription fill\u2010based estimates of glucocorticoid use and dose, and approximate bias from glucocorticoid exposure misclassification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified adults with rheumatoid arthritis with linked Medicare and CorEvitas registry data. An algorithm identifying glucocorticoid use and average dose over 90\u2009days from Medicare prescription fills was compared to physician\u2010reported measures from a CorEvitas visit during the same period, using weighted kappa to compare doses (none, \u22645\u2009mg, 5\u201310\u2009mg, &gt;10\u2009mg\/day). A deterministic sensitivity analysis examined the effect of exposure misclassification on estimated glucocorticoid\u2010associated infection risk from a prior study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 621 observations among 494 patients. Prescription fills identified glucocorticoid use in 41.9% of observations versus 31.1% identified by CorEvitas physician\u2010report. For glucocorticoid use (yes\/no), prescription fills had sensitivity 88.1% (95% CI 82.7\u201392.3), specificity 79.0% (74.8\u201382.7), PPV 65.4% (59.3\u201371.2), NPV 93.6% (90.6\u201395.9), and 81.8% agreement with CorEvitas, with kappa 0.61 (moderate to substantial agreement). There was 89.5% agreement between prescription fills and physician\u2010reported doses, with weighted kappa 0.56 (moderate agreement). Applying these results to a prior Medicare study evaluating glucocorticoid\u2010associated infection risk [risk ratio 1.44 (95% CI 1.41\u20131.48)] led to an externally adjusted risk ratio of 1.74 when accounting for exposure misclassification, representing \u221217% bias in infection risk estimate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study supports the use of claims data to estimate glucocorticoid use and dose, but investigators should account for exposure misclassification, which may lead to underestimates of glucocorticoid risks. Our results could be applied to adjust risk estimates in other studies that use prescription fills to estimate glucocorticoid use.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5660","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T17:59:13Z","timestamp":1687629553000},"page":"1271-1279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Accuracy of administrative claims prescription fill data to estimate glucocorticoid use and dose in patients with rheumatoid arthritis"],"prefix":"10.1002","volume":"32","author":[{"given":"Rachel W.","family":"Galvao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Yale University  New Haven Connecticut USA"},{"name":"Division of Rheumatology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie R.","family":"Harrold","sequence":"additional","affiliation":[{"name":"CorEvitas  Waltham Massachusetts USA"},{"name":"Division of Rheumatology University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qufei","family":"Wu","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-4801","authenticated-orcid":false,"given":"Fenglong","family":"Xie","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"George","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","first-page":"696","article-title":"Corticosteroid use in rheumatoid arthritis: prevalence, predictors, correlates, and outcomes","volume":"34","author":"Caplan L","year":"2007","journal-title":"J Rheumatol"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41752"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22312"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31805371bf"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20\u20101594"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010017\u20103679\u20104"},{"key":"e_1_2_9_8_1","unstructured":"Medicare Program \u2013 General Information | CMS. Accessed September 27 2021.https:\/\/www.cms.gov\/Medicare\/Medicare\u2010General\u2010Information\/MedicareGenInfo"},{"key":"e_1_2_9_9_1","unstructured":"CorEvitas.Corrona Rheumatoid Arthritis (RA) Drug Safety & Effectiveness Registry. clinicaltrials.gov.2021. 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