Table 2.
Case-Finding Algorithms with the Highest Sensitivity and Specificity of at Least 0.90 Using One Year of Claims
| Condition | Algorithm | Sensitivity | Specificity | LR+ | LR− |
|---|---|---|---|---|---|
| Hypertension | Diagnosis on 1 face-to-face claim and a pharmacy claim | 0.52 | 0.91 | 5.6 | 0.53 |
| Hypertension | Diagnosis on 2 face-to-face claims | 0.48 | 0.90 | 4.8 | 0.58 |
| Heart failure | Diagnosis on 1 claim | 0.58 | 0.93 | 7.0 | 0.45 |
| Chronic lung disease | Diagnosis on 1 face-to-face claim or a pharmacy claim | 0.56 | 0.91 | 6.6 | 0.48 |
| Chronic lung disease | Diagnosis on 1 face-to-face claim | 0.50 | 0.93 | 7.2 | 0.54 |
| Arthritis | Diagnosis on 1 face-to-face claim | 0.29 | 0.93 | 4.3 | 0.76 |
| Arthritis | Diagnosis on 2 or more claims | 0.28 | 0.94 | 4.7 | 0.77 |
| Glaucoma | Diagnosis on 1 claim or a pharmacy claim | 0.73 | 0.95 | 14 | 0.28 |
| Glaucoma | Diagnosis on 1 claim | 0.68 | 0.95 | 14 | 0.34 |
| Diabetes | Diagnosis on 1 claim or a pharmacy claim | 0.91 | 0.93 | 13 | 0.10 |
| Diabetes | Diagnosis on 1 claim | 0.90 | 0.93 | 13 | 0.11 |