This month the PNA Medical Corner features an article co-authored by multiple members of the PNA, including Drs. Kevin Yuen, Lewis Blevins and Maria Fleseriu. The co-authors have developed an algorithm that combs a database and predicts which people would benefit from further testing to see if they have Adult Growth Hormone Deficiency.

Development of a Novel Algorithm to Identify People with High Likelihood of Adult Growth Hormone Deficiency in a US Healthcare Claims Database

• PMID: 35761982

• DOI: 10.1155/2022/7853786

Abstract

Objective: Adult growth hormone deficiency (AGHD) is an underdiagnosed disease associated with increased morbidity and mortality. Identifying people who may benefit from growth hormone (GH) therapy can be challenging, as many AGHD symptoms resemble those of aging. We developed an algorithm to potentially help providers stratify people by their likelihood of having AGHD.

Design: The algorithm was developed with, and applied to, data in the anonymized Truven Health MarketScan® claims database. Patients. A total of 135 million adults in the US aged ≥18 years with ≥6 months of data in the Truven database. Measurements. Proportion of people with high, moderate, or low likelihood of having AGHD, and differences in demographic and clinical characteristics among these groups.

Results: Overall, 0.5%, 6.0%, and 93.6% of people were categorized into groups with high, moderate, or low likelihood of having AGHD, respectively. The proportions of females were 59.3%, 71.6%, and 50.4%, respectively. People in the high- and moderate-likelihood groups tended to be older than those in the low-likelihood group, with 58.3%, 49.0%, and 37.6% aged >50 years, respectively. Only 2.2% of people in the high-likelihood group received GH therapy as adults. The high-likelihood group had a higher incidence of comorbidities than the low-likelihood group, notably malignant neoplastic disease (standardized difference -0.42), malignant breast tumor (-0.27), hyperlipidemia (-0.26), hypertensive disorder (-0.25), osteoarthritis (-0.23), and heart disease (-0.22).

Conclusions: This algorithm may represent a cost-effective approach to improve AGHD detection rates by identifying appropriate patients for further diagnostic testing and potential GH replacement treatment.

Copyright © 2022 Kevin C. J. Yuen et al.

Conflict of interest statement:
KCJY has received research grants to Barrow Neurological Institute from Ascendis and has served on advisory boards for Ascendis, Pfizer, Sandoz, and Novo Nordisk. ACB, NK, TS, and JMT are employees of Novo Nordisk. LSB declares no conflicts of interest. DRC served as a consultant for Pfizer and Novo Nordisk. ARH has served on advisory boards for Novo Nordisk. ARH conducted this research as part of a personal outside consulting arrangement with Novo Nordisk. The research and research results are not, in any way, associated with Stanford University. JMK has no potential conflicts of interest to report. MF has received research support as principal investigator to OHSU from Ascendis and has been a scientific consultant to Ascendis, Novo Nordisk, and Pfizer.