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Promise and peril of claims-based dementia ascertainment in causal inference

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  • Contributors In this submission, we articulate several under-recognised factors that may bias research, policy and population health strategies predicated upon claims-based ascertainment of Alzheimer’s disease and related dementias (ADRD). The conceptual contributions in this manuscript build on core insights from the authors’ prior research focused on ADRD ascertainment and population risk-adjustment using electronic health record and administrative diagnostic information. NF is a geriatrician and postdoctoral fellow with expertise in claims-based measurement of ADRD. LMVRM is an associate professor of Neurology at Harvard Medical School with expertise in the claims-based measurement of ageing outcomes. DB is a professor of psychiatry at Harvard Medical School and in Epidemiology at the Harvard T.H. Chan School of Public Health, with expertise in assessment methods and epidemiology of neurodegenerative diseases. JPN is the JDM research professor of Health Policy and Management at Harvard University with expertise in health economics and health services research. JH (guarantor of this article) is an associate professor of Medicine at Harvard Medical School and director of the Massachusetts General Hospital Program for Clinical Economics and Policy Analysis, with expertise in health policy and alternative payment models.

  • Funding National Institute on Aging T32AG019134 (NF). National Institutes of Health, National Center for Advancing Translational Science TL1TR001864 (NF). National Institutes of Health—National Institute on Aging K08AG053380 (LMVRM). National Institutes of Health R01AG062282 (JH). National Institutes of Health P01AG032952 (JPN).

  • Competing interests We have read and understood BMJ policy on declaration of interests and have the following interests to declare: JH has consulted for Cambridge Health Alliance, Columbia University, Community Servings, Delta Health Alliance, the Robert Wood Johnson Foundation and the University of Southern California. The authors otherwise declare no conflicts of interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.