scholarly journals Development and Validation of an Administrative Case Definition for Inflammatory Bowel Diseases

2012 ◽  
Vol 26 (10) ◽  
pp. 711-717 ◽  
Author(s):  
Ali Rezaie ◽  
Hude Quan ◽  
Richard N Fedorak ◽  
Remo Panaccione ◽  
Robert J Hilsden
Keyword(s):  
Ambulatory Care ◽  
Classification System ◽  
Predictive Value ◽  
Population Based ◽  
Case Definition ◽  
Administrative Databases ◽  
Case Definitions ◽  
Health Region ◽  
System Database ◽  
Inflammatory Bowel

BACKGROUND: A population-based database of inflammatory bowel disease (IBD) patients is invaluable to explore and monitor the epidemiology and outcome of the disease. In this context, an accurate and validated population-based case definition for IBD becomes critical for researchers and health care providers.METHODS: IBD and non-IBD individuals were identified through an endoscopy database in a western Canadian health region (Calgary Health Region, Calgary, Alberta). Subsequently, using a novel algorithm, a series of case definitions were developed to capture IBD cases in the administrative databases. In the second stage of the study, the criteria were validated in the Capital Health Region (Edmonton, Alberta).RESULTS: A total of 150 IBD case definitions were developed using 1399 IBD patients and 15,439 controls in the development phase. In the validation phase, 318,382 endoscopic procedures were searched and 5201 IBD patients were identified. After consideration of sensitivity, specificity and temporal stability of each validated case definition, a diagnosis of IBD was assigned to individuals who experienced at least two hospitalizations or had four physician claims, or two medical contacts in the Ambulatory Care Classification System database with an IBD diagnostic code within a two-year period (specificity 99.8%; sensitivity 83.4%; positive predictive value 97.4%; negative predictive value 98.5%). An alternative case definition was developed for regions without access to the Ambulatory Care Classification System database. A novel scoring system was developed that detected Crohn disease and ulcerative colitis patients with a specificity of >99% and a sensitivity of 99.1% and 86.3%, respectively.CONCLUSION: Through a robust methodology, a reproducible set of criteria to capture IBD patients through administrative databases was developed. The methodology may be used to develop similar administrative definitions for chronic diseases.

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

2017 ◽  
Vol 44 (2) ◽  
pp. 161-169 ◽  
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.

scholarly journals Establishing the Incidence and Prevalence of Multiple Sclerosis in Saskatchewan

2018 ◽  
Vol 45 (3) ◽  
pp. 295-303 ◽  
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.

scholarly journals Improving an Administrative Case Definition for Longitudinal Surveillance of Sickle Cell Disease

2019 ◽  
Vol 134 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Angela B. Snyder ◽  
Mei Zhou ◽  
Rodney Theodore ◽  
Maa-Ohui Quarmyne ◽  
James Eckman ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Predictive Value ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Case Definition ◽  
Surveillance Systems ◽  
Cell Disease ◽  
Case Definitions ◽  
Sensitivity Specificity

Objective: Several states are building infrastructure and data collection methods for longitudinal, population-based surveillance systems for selected hemoglobinopathies. The objective of our study was to improve an administrative case definition for sickle cell disease (SCD) to aid in longitudinal surveillance. Methods: We collected data from 3 administrative data sets (2004-2008) on 1998 patients aged 0-21 in Georgia who had ≥1 encounter in which an SCD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code was recorded, and we compared these data with data from a laboratory and medical record review. We assessed performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of case definitions that differed by number and type of SCD-coded encounters; addition of SCD-associated treatments, procedures, and complications; and length of surveillance (1 vs 5 years). We identified correct diagnoses for patients who were incorrectly coded as having SCD. Results: The SCD case definition of ≥3 SCD-coded encounters in 5 years simplified and substantially improved the sensitivity (96.0% vs 85.8%) and NPV (68.2% vs 38.2%) of the original administrative case definition developed for 5-year, state-based surveillance (≥2 encounters in 5 years and ≥1 encounter for an SCD-related treatment, procedure, or complication), while maintaining a similar PPV (97.4% vs 97.4%) and specificity (76.5% vs 79.0%). Conclusions: This study supports an administrative case definition that specifies ≥3 ICD-9-CM–coded encounters to identify SCD with a high degree of accuracy in pediatric patients. This case definition can be used to help establish longitudinal SCD surveillance systems.

scholarly journals Developing and Validating an Algorithm to Identify Incident Chronic Dialysis Patients Using Administrative Data

2020 ◽  
Author(s):  
Dino Gibertoni ◽  
Claudio Voci ◽  
Marica Iommi ◽  
Benedetta D'Ercole ◽  
Marcora Mandreoli ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Administrative Data ◽  
Predictive Value ◽  
Healthcare Providers ◽  
High Sensitivity ◽  
Case Definition ◽  
Chronic Dialysis ◽  
Administrative Databases ◽  
Dialysis Patients ◽  
Case Definitions

Background: Administrative healthcare databases are widespread and are often standardized with regard to their content and data coding, thus they can be used also as data sources for surveillance and epidemiological research. Chronic dialysis requires patients to frequently access hospital and clinic services, causing a heavy burden to healthcare providers. This also means that these patients are routinely tracked on administrative databases, yet very few case definitions for their identification are currently available. The aim of this study was to develop two algorithms derived from administrative data for identifying incident chronic dialysis patients and test their validity compared to the reference standard of the regional dialysis registry. Methods: The algorithms are based on data retrieved from hospital discharge records (HDR) and ambulatory specialty visits (ASV) to identify incident chronic dialysis patients in an Italian region. Subjects are included if they have at least one event in the HDR or ASV databases based on the ICD9-CM dialysis-related diagnosis or procedure codes in the study period. Exclusion criteria comprise non-residents, prevalent cases, or patients undergoing temporary dialysis, and are evaluated only on ASV data by the first algorithm, on both ASV and HDR data by the second algorithm. We validated the algorithms against the Emilia-Romagna regional dialysis registry by searching for incident patients in 2014. Results: Algorithm 1 identified 680 patients and algorithm 2 identified 676 initiating dialysis in 2014, compared to 625 patients included in the regional dialysis registry. Sensitivity for the two algorithms was respectively 90.8% and 88.4%, positive predictive value 84.0% and 82.0%, and percentage agreement was 77.4% and 74.1%. Conclusions: These results suggest that administrative data have high sensitivity and positive predictive value for the identification of incident chronic dialysis patients. Algorithm 1, which showed the higher accuracy and has a simpler case definition, can be used in place of regional dialysis registries when they are not present or sufficiently developed in a region, or to improve the accuracy and timeliness of existing registries.

scholarly journals Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033334 ◽  
Author(s):  
Deborah A Marshall ◽  
Xiaoxiao Liu ◽  
Cheryl Barnabe ◽  
Karen Yee ◽  
Peter D Faris ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Age Groups ◽  
Population Based ◽  
Case Definition ◽  
Chronic Obstructive ◽  
Age Group ◽  
Case Definitions ◽  
Obstructive Pulmonary Disease ◽  
Physician Visits ◽  
Significant Difference

ObjectivesThe purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data.DesignRetrospective cohort analysis.SettingAll residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.Participants497 362 people with OA as defined by ‘having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years’.Primary outcome measuresWe selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied χ2 tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.Results54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (<45 years) having the highest percentage of cases with depression (24.6%), compared with a frequency of 16.1% in those >65 years.ConclusionsOur findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.

Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review

Cephalalgia ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 409-425 ◽  
Author(s):  
Maria L Westergaard ◽  
Ebba Holme Hansen ◽  
Charlotte Glümer ◽  
Jes Olesen ◽  
Rigmor H Jensen
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Large Population ◽  
Population Based ◽  
Case Definition ◽  
Practical Case ◽  
Case Definitions ◽  
Wide Range ◽  
Concurrent Medication ◽  
Over Time

Background Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta. Methods A systematic literature search was conducted to identify MOH prevalence studies. Findings were summarized according to diagnostic criteria. Results Twenty-seven studies were included. The commonly used case definition for MOH was headache ≥15 days/month with concurrent medication overuse ≥3 months. There were varying definitions for what was considered as overuse. Studies that all used ICHD-2 criteria showed a wide range of prevalence among adults: 0.5%–7.2%. Conclusions There are limits to comparing prevalence of MOH across studies and over time. The wide range of reported prevalence might not only be due to changing criteria, but also the diversity of countries now publishing data. The criterion “headache occurring on ≥15 days per month” with concurrent medication overuse can be applied in population-based studies. However, the new requirement that a respondent must have “a preexisting headache disorder” has not been previously validated. Exclusion of other headache diagnoses by expert evaluation and ancillary examinations is not feasible in large population-based studies.

scholarly journals Validation of Diagnosis and Procedure Codes for Revascularization for Peripheral Artery Disease in Ontario Administrative Databases

2021 ◽  
Vol 44 (2) ◽  
pp. E36-43
Author(s):  
Jean Jacob-Brassard ◽  
Mohammed Al-Omran ◽  
Thérèse A. Stukel ◽  
Muhammad Mamdani ◽  
Douglas S. Lee ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Peripheral Artery Disease ◽  
Predictive Value ◽  
Population Based ◽  
Administrative Databases ◽  
Peripheral Artery ◽  
Predictive Values ◽  
Diagnosis Codes ◽  
Artery Disease ◽  
Procedure Codes

Purpose: To estimate the positive predictive value of diagnosis and procedure codes for open and endovascular revascularization for peripheral artery disease (PAD) in Ontario administrative databases. Methods: We conducted a retrospective validation study using population-based Ontario administrative databases (2005-2019) to identify a random sample of 600 patients who underwent revascularization for PAD at two academic centres, based on ICD-10 diagnosis codes and Canada Classification of Health Intervention procedure codes. Administrative data coding was compared to the gold standard diagnosis (PAD vs. non-PAD) and revascularization approach (open vs. endovascular) extracted through blinded hospital chart re-abstraction. Positive predictive values and 95% confidence intervals were calculated. Combinations of procedure codes with or without supplemental physician claims codes were evaluated to optimize the positive predictive value. Results: The overall positive predictive value of PAD diagnosis codes was 87.5% (84.6%-90.0%). The overall positive predictive value of revascularization procedure codes was 94.3% (92.2%-96.0%), which improved through supplementation with physician fee claim codes to 98.1% (96.6%-99.0%). Algorithms to identify individuals revascularized for PAD had combined positive predictive values ranging from 82.8% (79.6%-85.8%) to 95.7% (93.5%-97.3%). Conclusion: Diagnosis and procedure codes with or without physician claims codes allow for accurate identifi-cation of individuals revascularized for PAD in Ontario administrative databases.

scholarly journals The Canadian Chronic Disease Surveillance System: A model for collaborative surveillance

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Lisa Lix ◽  
James Ayles ◽  
Sharon Bartholomew ◽  
Charmaine Cooke ◽  
Joellyn Ellison ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Health Agency ◽  
Population Based ◽  
Population Characteristics ◽  
Administrative Databases ◽  
Distributed Model ◽  
Case Definitions ◽  
Disease Surveillance System

Chronic diseases have a major impact on populations and healthcare systems worldwide. Administrative health data are an ideal resource for chronic disease surveillance because they are population-based and routinely collected. For multi-jurisdictional surveillance, a distributed model is advantageous because it does not require individual-level data to be shared across jurisdictional boundaries. Our objective is to describe the process, structure, benefits, and challenges of a distributed model for chronic disease surveillance across all Canadian provinces and territories (P/Ts) using linked administrative data. The Public Health Agency of Canada (PHAC) established the Canadian Chronic Disease Surveillance System (CCDSS) in 2009 to facilitate standardized, national estimates of chronic disease prevalence, incidence, and outcomes. The CCDSS primarily relies on linked health insurance registration files, physician billing claims, and hospital discharge abstracts. Standardized case definitions and common analytic protocols are applied to the data for each P/T; aggregate data are shared with PHAC and summarized for reports and open access data initiatives. Advantages of this distributed model include: it uses the rich data resources available in all P/Ts; it supports chronic disease surveillance capacity building in all P/Ts; and changes in surveillance methodology can be easily developed by PHAC and implemented by the P/Ts. However, there are challenges: heterogeneity in administrative databases across jurisdictions and changes in data quality over time threaten the production of standardized disease estimates; a limited set of databases are common to all P/Ts, which hinders potential CCDSS expansion; and there is a need to balance comprehensive reporting with P/T disclosure requirements to protect privacy. The CCDSS distributed model for chronic disease surveillance has been successfully implemented and sustained by PHAC and its P/T partners. Many lessons have been learned about national surveillance involving jurisdictions that are heterogeneous with respect to healthcare databases, expertise and analytical capacity, population characteristics, and priorities.

scholarly journals [Hospital morbidity in an urban district in Tunisia]

1998 ◽  
Vol 4 (1) ◽  
pp. 94-99
Author(s):  
Abdallah Bchir
Keyword(s):  
Ambulatory Care ◽  
Chronic Diseases ◽  
Population Based ◽  
Hospitalization Rate ◽  
Public Hospitals ◽  
Epidemiological Transition ◽  
Urban District ◽  
Health Region ◽  
Hospital Morbidity

In the health region of Monastir, Tunisia, there is a register of admissions to all public hospitals. Those relating to patients resident in Ksar Hellal District during the year 1995 were identified [N = 1983 admissions to hospital]. This made it possible to establish the population-based pattern of hospital morbidities. The annual hospitalization rate is 6.1%;the rate for patients aged ‘ 65 years is estimated at 13.1%. Chronic diseases are responsible for 31.5% of admissions to hospital and are predominantly diabetes and asthma. The morbidity pattern reflects a phenomenon of epidemiological transition and calls for the strengthening of ambulatory care and development of specific services likely to reduce the need for hospitalization

Systemic Autoimmune Rheumatic Disease Prevalence in Canada: Updated Analyses Across 7 Provinces

2014 ◽  
Vol 41 (4) ◽  
pp. 673-679 ◽  
Author(s):  
Laurel Broten ◽  
J. Antonio Aviña-Zubieta ◽  
Diane Lacaille ◽  
Lawrence Joseph ◽  
John G. Hanly ◽  
...  
Keyword(s):  
Rheumatic Disease ◽  
Lupus Erythematosus ◽  
Latent Class ◽  
Population Based ◽  
Case Definition ◽  
Case Definitions ◽  
Autoimmune Rheumatic Disease ◽  
Primary Sjögren Syndrome ◽  
Physician Billing ◽  
Systemic Autoimmune Rheumatic Disease

Objective.To estimate systemic autoimmune rheumatic disease (SARD) prevalence across 7 Canadian provinces using population-based administrative data evaluating both regional variations and the effects of age and sex.Methods.Using provincial physician billing and hospitalization data, cases of SARD (systemic lupus erythematosus, scleroderma, primary Sjögren syndrome, polymyositis/dermatomyositis) were ascertained. Three case definitions (rheumatology billing, 2-code physician billing, and hospital diagnosis) were combined to derive a SARD prevalence estimate for each province, categorized by age, sex, and rural/urban status. A hierarchical Bayesian latent class regression model was fit to account for the imperfect sensitivity and specificity of each case definition. The model also provided sensitivity estimates of different case definition approaches.Results.Prevalence estimates for overall SARD ranged between 2 and 5 cases per 1000 residents across provinces. Similar demographic trends were evident across provinces, with greater prevalence in women and in persons over 45 years old. SARD prevalence in women over 45 was close to 1%. Overall sensitivity was poor, but estimates for each of the 3 case definitions improved within older populations and were slightly higher for men compared to women.Conclusion.Our results are consistent with previous estimates and other North American findings, and provide results from coast to coast, as well as useful information about the degree of regional and demographic variations that can be seen within a single country. Our work demonstrates the usefulness of using multiple data sources, adjusting for the error in each, and providing estimates of the sensitivity of different case definition approaches.

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