Inferring Palliative Intent From Administrative Data: Validation of a Claims-Based Case Definition for Venting Gastrostomy Tube

AbstractBackgroundDiscrepancies between population-based estimates of the incidence of psychotic disorder and the treated incidence reported by early psychosis intervention (EPI) programs suggest additional cases may be receiving services elsewhere in the health system. Our objective was to estimate the incidence of non-affective psychotic disorder in the catchment area of an EPI program, and compare this to EPI-treated incidence estimates.MethodsWe constructed a retrospective cohort (1997–2015) of incident cases of non-affective psychosis aged 16–50 years in an EPI program catchment using population-based linked health administrative data. Cases were identified by either one hospitalization or two outpatient physician billings within a 12-month period with a diagnosis of non-affective psychosis. We estimated the cumulative incidence and EPI-treated incidence of non-affective psychosis using denominator data from the census. We also estimated the incidence of first-episode psychosis (people who would meet the case definition for an EPI program) using a novel approach.ResultsOur case definition identified 3245 cases of incident non-affective psychosis over the 17-year period. We estimate that the incidence of first-episode non-affective psychosis in the program catchment area is 33.3 per 100 000 per year (95% CI 31.4–35.1), which is more than twice as high as the EPI-treated incidence of 18.8 per 100 000 per year (95% CI 17.4–20.3).ConclusionsCase ascertainment strategies limited to specialized psychiatric services may substantially underestimate the incidence of non-affective psychotic disorders, relative to population-based estimates. Accurate information on the epidemiology of first-episode psychosis will enable us to more effectively resource EPI services and evaluate their coverage.

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Validation of a Case Definition for Pediatric Brain Injury Using Administrative Data

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.419 ◽

2017 ◽

Vol 44 (2) ◽

pp. 161-169 ◽

Cited By ~ 3

Author(s):

Jane McChesney-Corbeil ◽

Karen Barlow ◽

Hude Quan ◽

Guanmin Chen ◽

Samuel Wiebe ◽

...

Keyword(s):

Brain Injury ◽

Administrative Data ◽

Predictive Value ◽

External Validation ◽

Secondary Data ◽

Population Based ◽

Case Definition ◽

Case Definitions ◽

Icd 10 ◽

Pediatric Tbi

AbstractBackground: Health administrative data are a common population-based data source for traumatic brain injury (TBI) surveillance and research; however, before using these data for surveillance, it is important to develop a validated case definition. The objective of this study was to identify the optimal International Classification of Disease , edition 10 (ICD-10), case definition to ascertain children with TBI in emergency room (ER) or hospital administrative data. We tested multiple case definitions. Methods: Children who visited the ER were identified from the Regional Emergency Department Information System at Alberta Children’s Hospital. Secondary data were collected for children with trauma, musculoskeletal, or central nervous system complaints who visited the ER between October 5, 2005, and June 6, 2007. TBI status was determined based on chart review. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each case definition. Results: Of 6639 patients, 1343 had a TBI. The best case definition was, “1 hospital or 1 ER encounter coded with an ICD-10 code for TBI in 1 year” (sensitivity 69.8% [95% confidence interval (CI), 67.3-72.2], specificity 96.7% [95% CI, 96.2-97.2], PPV 84.2% [95% CI 82.0-86.3], NPV 92.7% [95% CI, 92.0-93.3]). The nonspecific code S09.9 identified >80% of TBI cases in our study. Conclusions: The optimal ICD-10–based case definition for pediatric TBI in this study is valid and should be considered for future pediatric TBI surveillance studies. However, external validation is recommended before use in other jurisdictions, particularly because it is plausible that a larger proportion of patients in our cohort had milder injuries.

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The Use of Administrative Data to Investigate the Population Burden of Hepatic Encephalopathy

Journal of Clinical Medicine ◽

10.3390/jcm9113620 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3620

Author(s):

Patricia P. Bloom ◽

Elliot B. Tapper

Keyword(s):

Health Care ◽

Hepatic Encephalopathy ◽

Administrative Data ◽

Case Definition ◽

Health Care Resource ◽

Careful Attention ◽

Global Public Health ◽

Health Care Resource Utilization ◽

Secondary Purpose ◽

Careful History

Hepatic encephalopathy (HE) is a devastating complication of cirrhosis with an increasing footprint in global public health. Although the condition is defined using a careful history and examination, we cannot accurately measure the true impact of HE relying on data collected exclusively from clinical studies. For this reason, administrative data sources are necessary to study the population burden of HE. Administrative data is generated with each health care encounter to account for health care resource utilization and is extracted into a dataset for the secondary purpose of research. In order to utilize such data for valid analysis, several pitfalls must be avoided—specifically, selecting the particular database capable of meeting the needs of the study’s aims, paying careful attention to the limits of each given database, and ensuring validity of case definition for HE specific to the dataset. In this review, we summarize the types of data available for and the results of administrative data studies of HE.

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Accuracy of Administrative Data for the Coding of Acute Stroke and TIAs

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.278 ◽

2016 ◽

Vol 43 (6) ◽

pp. 765-773 ◽

Cited By ~ 20

Author(s):

Ruth Hall ◽

Luke Mondor ◽

Joan Porter ◽

Jiming Fang ◽

Moira K. Kapral

Keyword(s):

Ischemic Stroke ◽

Acute Stroke ◽

Administrative Data ◽

Data Validation ◽

Reference Standard ◽

Stroke Registry ◽

Diagnostic Codes ◽

Icd 10 ◽

Stroke Type ◽

Ischemic Attack

AbstractObjective: Administrative data validation is essential for identifying biases and misclassification in research. The objective of this study was to determine the accuracy of diagnostic codes for acute stroke and transient ischemic attack (TIA) using the Ontario Stroke Registry (OSR) as the reference standard. Methods: We identified stroke and TIA events in inpatient and emergency department (ED) administrative data from eight regional stroke centres in Ontario, Canada, from April of 2006 through March of 2008 using ICD–10–CA codes for subarachnoid haemorrhage (I60, excluding I60.8), intracerebral haemorrhage (I61), ischemic (H34.1 and I63, excluding I63.6), unable to determine stroke (I64), and TIA (H34.0 and G45, excluding G45.4). We linked administrative data to the Ontario Stroke Registry and calculated sensitivity and positive predictive value (PPV). Results:: We identified 5,270 inpatient and 4,411 ED events from the administrative data. Inpatient administrative data had an overall sensitivity of 82.2% (95% confidence interval [CI95%]=81.0, 83.3) and a PPV of 68.8% (CI95%=67.5, 70.0) for the diagnosis of stroke, with notable differences observed by stroke type. Sensitivity for ischemic stroke increased from 66.5 to 79.6% with inclusion of I64. The sensitivity and PPV of ED administrative data for diagnosis of stroke were 56.8% (CI95%=54.8, 58.7) and 59.1% (CI95%=57.1, 61.1), respectively. For all stroke types, accuracy was greater in the inpatient data than in the ED data. Conclusion: The accuracy of stroke identification based on administrative data from stroke centres may be improved by including I64 in ischemic stroke type, and by considering only inpatient data.

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Validating a case definition for chronic kidney disease using administrative data

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfr598 ◽

2011 ◽

Vol 27 (5) ◽

pp. 1826-1831 ◽

Cited By ~ 46

Author(s):

P. E. Ronksley ◽

M. Tonelli ◽

H. Quan ◽

B. J. Manns ◽

M. T. James ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Administrative Data ◽

Case Definition

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Linking Clinical and Administrative Data to Inform Performance Measures Regarding Access to Specialist Care for Patients with Rheumatoid Arthritis

International Journal for Population Data Science ◽

10.23889/ijpds.v3i4.1030 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Deborah A Marshall ◽

Claire Barber ◽

Sharon Zhang ◽

Jatin Patel ◽

Guanmin Chen ◽

...

Keyword(s):

Administrative Data ◽

Performance Measure ◽

Case Definition ◽

Fiscal Year ◽

Specialist Care ◽

Data Repositories ◽

Physician Visits ◽

Icd 10 ◽

One Year ◽

New Onset

IntroductionRheumatoid arthritis (RA) is the most prevalent type of chronic adult inflammatory arthritis and requires timely diagnosis and subsequent access to specialist care and treatment from a rheumatologist. We developed a set of key performance indicators (KPIs) to evaluate access, effectiveness, acceptability, appropriateness and efficiency of care. Objectives and ApproachThe overall objective was to measure performance of a central intake system for referral to rheumatology against the KPIs. We report on one accessibility KPIs: the percentage of patients with new onset RA with at least one visit to a rheumatologist in the first 365 days since diagnosis. We identified a cohort of RA patients using a validated case definition: >16 years, at least 1 RA related hospitalization (ICD-10-CA:M05.x-M06.x) or two RA related physician visits ≥ eight weeks apart within two years (ICD-9: 714.x). The incident case date was date of hospitalization or second physician visit (whichever came first). ResultsThis KPI assessed the proportion of patients seen by a rheumatologist within one year of first RA visit by patients in the RA cohort. 13,914 cases of RA were diagnosed between April 1 2010 and March 31 2016. The percentage of patients with new onset RA with at least one visit to a rheumatologist in the first 365 days since diagnosis increased between fiscal years 2011 and 2015. Of the 2851 incident RA cases in fiscal year 2011, 1490 (53%) met the performance measure compared to 1710 of 2710 (63%) who met the definition in fiscal year 2015. Other KPIs, including wait times, are being evaluated using both clinical and administrative data. Conclusion/ImplicationsBy linking multiple administrative datasets, we are able to measure system performance against a defined KPI and identify opportunities for system improvement. This is the first initiative in Alberta for patients with RA where data from different multi-custodial data repositories have been extracted, linked and analyzed for this purpose.

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Validation of a case definition for depression in administrative data against primary chart data as a reference standard

BMC Psychiatry ◽

10.1186/s12888-018-1990-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 24

Author(s):

Chelsea Doktorchik ◽

Scott Patten ◽

Cathy Eastwood ◽

Mingkai Peng ◽

Guanmin Chen ◽

...

Keyword(s):

Administrative Data ◽

Case Definition ◽

Reference Standard

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Validating an administrative data-based case definition for identifying children and youth with autism spectrum disorder for surveillance purposes

Can J Public Health ◽

10.17269/cjph.108.5963 ◽

2017 ◽

Vol 108 (5-6) ◽

pp. e530-e538 ◽

Cited By ~ 5

Author(s):

Helen Coo ◽

Hélène Ouellette-Kuntz ◽

Marni Brownell ◽

Shahin Shooshtari ◽

Ana Hanlon-Dearman

Keyword(s):

Autism Spectrum Disorder ◽

Administrative Data ◽

Autism Spectrum ◽

Case Definition ◽

Spectrum Disorder ◽

Children And Youth

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Establishing the Incidence and Prevalence of Multiple Sclerosis in Saskatchewan

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2017.301 ◽

2018 ◽

Vol 45 (3) ◽

pp. 295-303 ◽

Cited By ~ 20

Author(s):

Lina H. Al-Sakran ◽

Ruth Ann Marrie ◽

David F. Blackburn ◽

Katherine B. Knox ◽

Charity D. Evans

Keyword(s):

Multiple Sclerosis ◽

Administrative Data ◽

Predictive Value ◽

Disease Surveillance ◽

Population Based ◽

Case Definition ◽

Case Definitions ◽

Health Administrative Data ◽

Disease Surveillance System ◽

Definition Of

AbstractObjective: To validate a case definition of multiple sclerosis (MS) using health administrative data and to provide the first province-wide estimates of MS incidence and prevalence for Saskatchewan, Canada. Methods: We used population-based health administrative data between January 1, 1996 and December 31, 2015 to identify individuals with MS using two potential case definitions: (1) ≥3 hospital, physician, or prescription claims (Marrie definition); (2) ≥1 hospitalization or ≥5 physician claims within 2 years (Canadian Chronic Disease Surveillance System [CCDSS] definition). We validated the case definitions using diagnoses from medical records (n=400) as the gold standard. Results: The Marrie definition had a sensitivity of 99.5% (95% confidence interval [CI] 92.3-99.2), specificity of 98.5% (95% CI 97.3-100.0), positive predictive value (PPV) of 99.5% (95% CI 97.2-100.0), and negative predictive value (NPV) of 97.5% (95% CI 94.4-99.2). The CCDSS definition had a sensitivity of 91.0% (95% CI 81.2-94.6), specificity of 99.0% (95% CI 96.4-99.9), PPV of 98.9% (95% CI 96.1-99.9), and NPV of 91.7% (95% CI 87.2-95.0). Using the more sensitive Marrie definition, the average annual adjusted incidence per 100,000 between 2001 and 2013 was 16.5 (95% CI 15.8-17.2), and the age- and sex-standardized prevalence of MS in Saskatchewan in 2013 was 313.6 per 100,000 (95% CI 303.0-324.3). Over the study period, incidence remained stable while prevalence increased slightly. Conclusion: We confirm Saskatchewan has one of the highest rates of MS in the world. Similar to other regions in Canada, incidence has remained stable while prevalence has gradually increased.

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