Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid

Abstract Introduction Rare events data have proven difficult to explain and predict. Standard statistical procedures can sharply underestimate the probability of rare events, such as intravenous immune globulin therapy (IVIg) for bullous pemphigoid. Methods This retrospective cross-sectional study u...

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Main Authors: Onur Baser, Huseyin Yuce, Gabriela Samayoa
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Medical Research Methodology
Subjects:
Online Access:https://doi.org/10.1186/s12874-025-02559-5
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author Onur Baser
Huseyin Yuce
Gabriela Samayoa
author_facet Onur Baser
Huseyin Yuce
Gabriela Samayoa
author_sort Onur Baser
collection DOAJ
description Abstract Introduction Rare events data have proven difficult to explain and predict. Standard statistical procedures can sharply underestimate the probability of rare events, such as intravenous immune globulin therapy (IVIg) for bullous pemphigoid. Methods This retrospective cross-sectional study used Department of Defense TRICARE data to determine factors associated with IVIg therapy among bullous pemphigoid patients. We used prior and weighted correction methods for logit regression to solve rare event bias. Results We identified 2,720 individuals diagnosed with bullous pemphigoid from 2019 to 2022, of which 14 were treated with IVIg. Patients who received IVIg therapy were younger (65.07 vs. 75.85, P =.0016) and more likely to be female (13 vs. 1, P =.0036). The underestimation with the standard regression model for event probabilities ranged from 11% to 102% using the prior correction method and from 15% to 107% using the weighted correction method. Conclusion Rare events are low-frequency, high-severity problems that can have significant consequences. Rare diseases and rare therapies are individually unique but collectively contribute to substantial health and social needs. Therefore, correct estimation of the events is the first step toward assessing the burden of rare diseases and the pricing of their therapies.
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spelling doaj-art-c2ad2cbc83b34853b736ab36b2fde9e72025-08-20T02:19:58ZengBMCBMC Medical Research Methodology1471-22882025-04-012511910.1186/s12874-025-02559-5Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoidOnur Baser0Huseyin Yuce1Gabriela Samayoa2John D. Dingell VA CenterNew York City College of TechnologyColumbia Data AnalyticsAbstract Introduction Rare events data have proven difficult to explain and predict. Standard statistical procedures can sharply underestimate the probability of rare events, such as intravenous immune globulin therapy (IVIg) for bullous pemphigoid. Methods This retrospective cross-sectional study used Department of Defense TRICARE data to determine factors associated with IVIg therapy among bullous pemphigoid patients. We used prior and weighted correction methods for logit regression to solve rare event bias. Results We identified 2,720 individuals diagnosed with bullous pemphigoid from 2019 to 2022, of which 14 were treated with IVIg. Patients who received IVIg therapy were younger (65.07 vs. 75.85, P =.0016) and more likely to be female (13 vs. 1, P =.0036). The underestimation with the standard regression model for event probabilities ranged from 11% to 102% using the prior correction method and from 15% to 107% using the weighted correction method. Conclusion Rare events are low-frequency, high-severity problems that can have significant consequences. Rare diseases and rare therapies are individually unique but collectively contribute to substantial health and social needs. Therefore, correct estimation of the events is the first step toward assessing the burden of rare diseases and the pricing of their therapies.https://doi.org/10.1186/s12874-025-02559-5Modeling rare eventsRare diseaseRare therapiesBullous pemphigoidImmune globulin therapy
spellingShingle Onur Baser
Huseyin Yuce
Gabriela Samayoa
Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid
BMC Medical Research Methodology
Modeling rare events
Rare disease
Rare therapies
Bullous pemphigoid
Immune globulin therapy
title Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid
title_full Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid
title_fullStr Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid
title_full_unstemmed Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid
title_short Analysis of rare events in healthcare intervention using department of defense data: intravenous immune globulin therapy for bullous pemphigoid
title_sort analysis of rare events in healthcare intervention using department of defense data intravenous immune globulin therapy for bullous pemphigoid
topic Modeling rare events
Rare disease
Rare therapies
Bullous pemphigoid
Immune globulin therapy
url https://doi.org/10.1186/s12874-025-02559-5
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