{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T01:38:56Z","timestamp":1778549936449,"version":"3.51.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Human papillomavirus vaccine (HPV) impact on cervical precancer (cervical intraepithelial neoplasia grades 2+ [CIN2+]) is observable sooner than impact on cancer. Biopsy-confirmed CIN2+ is not included in most US cancer registries. Billing codes could provide surrogate metrics; however, the International Classification of Diseases, ninth (ICD-9) to tenth (ICD-10) transition disrupts trends. We built, validated, and compared claims-based models to identify CIN2+ events in both ICD eras.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A database of Davidson County (Nashville), Tennessee, pathology-confirmed CIN2+ from the HPV Vaccine Impact Monitoring Project (HPV-IMPACT) provided gold standard events. Using Tennessee Medicaid 2008-2017, cervical diagnostic procedures (N\u2009=\u20098549) among Davidson County women aged 18-39\u2009years were randomly split into 60% training and 40% testing sets. Relevant diagnosis, procedure, and screening codes were used to build models from CIN2+ tissue diagnosis codes alone, least absolute shrinkage and selection operator (LASSO), and random forest. Model-classified index events were counted to estimate incident events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HPV-IMPACT identified 983 incident CIN2+ events. Models identified 1007 (LASSO), 1245 (CIN2+ tissue diagnosis codes alone), and 957 (random forest) incident events. LASSO performed well in ICD-9 and ICD-10 eras: 77.3% (95% confidence interval [CI] = 72.5% to 81.5%) vs 81.1% (95% CI\u2009=\u200971.5% to 88.6%) sensitivity, 93.0% (95% CI\u2009=\u200991.9% to 94.0%) vs 90.2% (95% CI\u2009=\u200987.2% to 92.7%) specificity, 61.3% (95% CI\u2009=\u200956.6% to 65.8%) vs 60.3% (95% CI\u2009=\u200951.0% to 69.1%) positive predictive value, 96.6% (95% CI\u2009=\u200995.8% to 97.3%) vs 96.3% (95% CI\u2009=\u200994.1% to 97.8%) negative predictive value, 91.0% (95% CI\u2009=\u200989.9% to 92.1%) vs 88.8% (95% CI\u2009=\u200985.9% to 91.2%) accuracy, and 85.1% (95% CI\u2009=\u200982.9% to 87.4%) vs 85.6% (95% CI\u2009=\u200981.4% to 89.9%) C-indices, respectively; performance did not statistically significantly differ between eras (95% confidence intervals all overlapped).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results confirmed model utility with good performance across both ICD eras for CIN2+ surveillance. Validated claims-based models may be used in future CIN2+ trend analyses to estimate HPV vaccine impact where population-based biopsies are unavailable.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jncics\/pkaa112","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T03:11:36Z","timestamp":1607483496000},"source":"Crossref","is-referenced-by-count":3,"title":["Improving Cervical Precancer Surveillance: Validity of Claims-Based Prediction Models in ICD-9 and ICD-10 Eras"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7064-4424","authenticated-orcid":false,"given":"Jaimie Z","family":"Shing","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie R","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Vanderbilt 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manideepthi","family":"Pemmaraju","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa B","family":"Rentuza","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4412-9087","authenticated-orcid":false,"given":"Pamela C","family":"Hull","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA"},{"name":"Department of Behavioral Science, University of Kentucky Markey Cancer Center, Lexington, KY, 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