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Insurance Claim Review

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Claims-Based Algorithms for Identifying Patients With Pulmonary Hypertension: A Comparison of Decision Rules and Machine-Learning Approaches.

Journal of the American Heart Association
Background Real-world healthcare data are an important resource for epidemiologic research. However, accurate identification of patient cohorts-a crucial first step underpinning the validity of research results-remains a challenge. We developed and e...

Identifying drugs with disease-modifying potential in Parkinson's disease using artificial intelligence and pharmacoepidemiology.

Pharmacoepidemiology and drug safety
PURPOSE: The aim of the study was to assess the feasibility of an approach combining computational methods and pharmacoepidemiology to identify potentially disease-modifying drugs in Parkinson's disease (PD).

Evaluating the performance of a predictive modeling approach to identifying members at high-risk of hospitalization.

Journal of medical economics
To evaluate the risk-of-hospitalization (ROH) models developed at Blue Cross Blue Shield of Louisiana (BCBSLA) and compare this approach to the DxCG risk-score algorithms utilized by many health plans. Time zero for this study was December 31, 2016....

Combining the Power of Artificial Intelligence with the Richness of Healthcare Claims Data: Opportunities and Challenges.

PharmacoEconomics
Combinations of healthcare claims data with additional datasets provide large and rich sources of information. The dimensionality and complexity of these combined datasets can be challenging to handle with standard statistical analyses. However, rece...

Using Machine Learning Applied to Real-World Healthcare Data for Predictive Analytics: An Applied Example in Bariatric Surgery.

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
OBJECTIVES: Laparoscopic metabolic surgery (MxS) can lead to remission of type 2 diabetes (T2D); however, treatment response to MxS can be heterogeneous. Here, we demonstrate an open-source predictive analytics platform that applies machine-learning ...