Estimating Prevalence, Demographics and Costs of ME/CFS Using Large Scale Medical Claims Data and Machine Learning

Abstract:

Techniques of data mining and machine learning were applied to a large database of medical and facility claims from commercially insured patients to determine the prevalence, gender demographics, and costs for individuals with provider-assigned diagnosis codes for myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). The frequency of diagnosis was 519 – 1,038/100,000 with the relative risk of females being diagnosed with ME or CFS compared to males 1.238 and 1.178, respectively. While the percentage of women diagnosed with ME/CFS is higher than the percentage of men, ME/CFS is not a “woman’s disease.” Thirty-five to forty percent of diagnosed patients are men. Extrapolating from this frequency of diagnosis and based on the estimated 2017 population of the United States, a rough estimate for the number of patients who may be diagnosed with ME or CFS in the U.S. is 1.7 million to 3.38 million.

Patients diagnosed with CFS appear to represent a more heterogeneous group than those diagnosed with ME. A machine learning model based on characteristics of individuals diagnosed with ME was developed and applied, resulting in a predicted prevalence of 857/100,000 (p>0.01), or roughly 2.8 million in the U.S.

Average annual costs for individuals with a diagnosis of ME or CFS were compared with those for lupus (all categories) and multiple sclerosis (MS), and found to be 50% higher for ME and CFS than for lupus or MS, and three to four times higher than for the general insured population.

A separate aspect of the study attempted to determine if a diagnosis of ME or CFS could be predicted based on symptom codes in the insurance claims records. Due to the absence of specific codes for some core symptoms, we were unable to validate that the information in insurance claims records is sufficient to identify diagnosed patients or suggest that a diagnosis of ME or CFS should be considered based solely on looking for presence of those symptoms.

These results show that a prevalence rate of 857/100,000 for ME/CFS is not unreasonable; therefore, it is not a rare disease, but in fact a relatively common one.

Source: Ashley Valdez, Elizabeth E. Hancock, Seyi Adebayo, David Kiernicki, Daniel Proskauer, John R. Attewell, Lucinda Bateman, Alfred DeMaria, Jr, Charles W. Lapp, Peter C. Rowe and Charmian Proskauer. Estimating Prevalence, Demographics and Costs of ME/CFS Using Large Scale Medical Claims Data and Machine Learning. Front. Pediatr. | doi: 10.3389/fped.2018.00412  https://www.frontiersin.org/articles/10.3389/fped.2018.00412/full (Full article)

Chronic fatigue syndrome–also an insurance medicine problem

Abstract:

Not everybody who is chronically tired has a chronic fatigue syndrome. The diagnosis of the chronic fatigue syndrome is still a problem, and is becoming a problem in health insurance medicine too. There is a lack of knowledge concerning the causes, the diagnosis and the therapy of the chronic fatigue syndrome. And there is still the question if the chronic fatigue syndrome is an entity of its own. For these reasons we should apply the few facts we really know about the chronic fatigue syndrome. This is the working case definition of Kaplan et al. from 1988. Otherwise there will be done hundreds of expensive laboratory tests, which are useless for the patient and very costly for the health insurance companies.

 

Source: Hakimi R. Chronic fatigue syndrome–also an insurance medicine problem. Versicherungsmedizin. 1996 Apr 1;48(2):59-61. [Article in German] http://www.ncbi.nlm.nih.gov/pubmed/8659056