The Bynum-Standard 1-Year Algorithm:
Here, you will find resources to use the Bynum-Standard 1-Year Algorithm including a README file that accompanies SAS and Stata scripts for the 1-Year Standard Method for identifying Alzheimer’s Disease and Related Dementias (ADRD) in Medicare Claims data. Files are linked above.
There are seven script files (plus a parameters file for SAS [parm.sas]) for both SAS and Stata. The files are numbered in the order in which they should be run; the five “1” files may be run in any order.
The full algorithm requires access to a single year of Medicare Claims data for (1) MedPAR, (2) Home Health Agency (HHA) Claims File, (3) Hospice Claims File, (4) Carrier Claims and Line Files, and (5) Hospital Outpatient File (HOF) Claims and Revenue Files. All Medicare Claims files are expected to be in SAS format (.sas7bdat).
For each data source, the script will output three files*:
- Diagnosis-level file: Lists individual ADRD diagnoses for each beneficiary for a given visit. This file allows researchers to identify which ICD-9-CM or ICD-10-CM codes are used in the claims data.
- Service Date-level file: Aggregated from the Diagnosis-level file, this file includes all beneficiaries with an ADRD diagnosis by Service Date (date of a claim with at least one ADRD diagnosis).
- Beneficiary-level file: Aggregated from the Service Date-level file, this file includes all beneficiaries with at least one* ADRD diagnosis at any point in the year within a specific file
* The algorithm combines the Carrier and HOF files at the Service Date-level. The final combined Carrier and HOF Beneficiary-level file includes those with at least two (2) claims that are seven (7) or more days apart.
A final combined file is created by merging all Beneficiary-level files. This file is used to identify beneficiaries with ADRD and can be merged onto other files by the Beneficiary ID (BENE_ID).
With appreciation & acknowledgement to colleagues at the NIA IMPACT Collaboratory for their involvement in development & validation of the Bynum-Standard 1-Year Algorithm:
McCarthy EP, Chang CH, Tilton N, Kabeto MU, Langa KM, Bynum JPW. Validation of Claims Algorithms to Identify Alzheimer's Disease and Related Dementias. J Gerontol A Biol Sci Med Sci. 2022;77(6):1261-1271. doi:10.1093/gerona/glab373 [PMID 34919686]
McCreedy E, Gilmore-Bykovskyi A, Dorr DA, et al. Barriers to identifying residents with dementia for embedded pragmatic trials: A call to action. J Am Geriatr Soc. 2022;70(2):638-641. doi:10.1111/jgs.17539 [PMID: 34727369]