Study Design and Data Source

This population-based retrospective cohort study was performed using administrative claims data from Optum’s deidentified Clinformatics Data Mart (CDM) (2003–2021) and IBM MarketScan Research Database (2007–2016). The CDM Database (OptumInsight) is a deidentified commercial and Medicare Advantage claims database. CDM includes data on approximately 15 to 18 million annual enrollees, for a total of > 63 million individuals from a geographically diverse population spanning all 50 states of the United States. CDM provides demographic and medical claims data for all inpatient and outpatient services, including ambulatory surgery. The IBM MarketScan Databases include > 240 million individuals insured by 350 unique health carriers. MarketScan data include health insurance claims across the continuum of care (e.g., inpatient, outpatient, outpatient pharmacy, and carve-out behavioral health care) and enrollment data from large employers and health plans across the United States. Both medical claims data sets include the International Classification of Disease, ninth and 10th revisions (ICD-9-CM and ICD-10-CM, respectively) diagnosis codes and Current Procedural Terminology (CPT), version 4, procedural codes. Data access for this project was provided by the Stanford Center for Population Health Science Data Core, which is supported by the National Institutes of Health National Center for the Advancing Translational Science Clinical and Translational Science Award (UL1 TR001085) and internal Stanford funding. The content of this article is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health. The Stanford School of Medicine Institutional Review Board determined that this study involving the use of deidentified data did not require institutional review board approval. The study adhered to the Declaration of Helsinki.