scholarly journals Identifying Primary Spontaneous Pneumothorax from Administrative Databases: A Validation Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Eric Frechette ◽  
Keegan Guidolin ◽  
Ayman Seyam ◽  
Yun-Hee Choi ◽  
Sarah Jones ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Large Population ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Epidemiological Studies ◽  
Population Based ◽  
Primary Spontaneous Pneumothorax ◽  
Administrative Databases ◽  
Main Diagnosis ◽  
Hospital Administrative

Introduction. Primary spontaneous pneumothorax (PSP) is a disorder commonly encountered in healthy young individuals. There is no differentiation between PSP and secondary pneumothorax (SP) in the current version of the International Classification of Diseases (ICD-10). This complicates the conduct of epidemiological studies on the subject.Objective. To validate the accuracy of an algorithm that identifies cases of PSP from administrative databases.Methods. The charts of 150 patients who consulted the emergency room (ER) with a recorded main diagnosis of pneumothorax were reviewed to define the type of pneumothorax that occurred. The corresponding hospital administrative data collected during previous hospitalizations and ER visits were processed through the proposed algorithm. The results were compared over two different age groups.Results. There were 144 cases of pneumothorax correctly coded (96%). The results obtained from the PSP algorithm demonstrated a significantly higher sensitivity (97% versus 81%,p=0.038) and positive predictive value (87% versus 46%,p<0.001) in patients under 40 years of age than in older patients.Conclusions. The proposed algorithm is adequate to identify cases of PSP from administrative databases in the age group classically associated with the disease. This makes possible its utilization in large population-based studies.

scholarly journals The prevalence of diagnosed α1-antitrypsin deficiency and its comorbidities: results from a large population-based database

2016 ◽  
Vol 49 (1) ◽  
pp. 1600154 ◽  
Author(s):  
Timm Greulich ◽  
Christoph Nell ◽  
David Hohmann ◽  
Marco Grebe ◽  
Sabina Janciauskiene ◽  
...  
Keyword(s):  
Large Population ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Healthcare Utilisation ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Chronic Obstructive ◽  
Healthcare Database ◽  
Obstructive Pulmonary Disease ◽  
Antitrypsin Deficiency

α1-Antitrypsin deficiency (AATD) is a genetically determined disorder that is associated with different clinical manifestations. We aimed to assess the prevalence of diagnosed AATD and its comorbidities using a large healthcare database.In this retrospective longitudinal observational study, we analysed data from 4 million insurants. Using International Classification of Diseases revision 10 (ICD-10) codes, we assessed the prevalence, comorbidities and healthcare utilisation of AATD patients (E88.0 repeatedly coded) relative to non-AATD patients with chronic obstructive pulmonary disease (COPD), emphysema or asthma.In our study population, we identified 673 AATD patients (590 aged ≥30 years), corresponding to a prevalence of 23.73 per 100 000 in all age groups and 29.36 per 100 000 in those ≥30 years. Based on the number of AATD cases detected in the sample size (673 out of 2 836 585), we extrapolated that there were 19 162 AATD cases in Germany during the years studied. AATD patients had a higher prevalence of arterial hypertension, chronic kidney disease and diabetes relative to non-AATD asthma or emphysema patients. When compared to non-AATD COPD patients, AATD patients had significantly more consultations and more frequent and longer hospitalisations.Our data strengthen the assumption that AATD is associated with a variety of other diseases. Healthcare utilisation appears to be higher among AATD patients as compared to patients with non-AATD-related obstructive lung diseases.

scholarly journals Netherlands Twin Register: From Twins to Twin Families

2006 ◽  
Vol 9 (6) ◽  
pp. 849-857 ◽  
Author(s):  
Dorret I. Boomsma ◽  
Eco J. C. de Geus ◽  
Jacqueline M. Vink ◽  
Janine H. Stubbe ◽  
Marijn A. Distel ◽  
...  
Keyword(s):  
Large Population ◽  
Epidemiological Studies ◽  
Population Based ◽  
Adolescent And Young Adult ◽  
City Councils ◽  
Blood And Urine Samples ◽  
Twin Families ◽  
New Research ◽  
Adult Twins ◽  
National Databases

AbstractIn the late 1980s The Netherlands Twin Register (NTR) was established by recruiting young twins and multiples at birth and by approaching adolescent and young adult twins through city councils. The Adult NTR (ANTR) includes twins, their parents, siblings, spouses and their adult offspring. The number of participants in the ANTR who take part in survey and / or laboratory studies is over 22,000 subjects. A special group of participants consists of sisters who are mothers of twins. In the Young NTR (YNTR), data on more than 50,000 young twins have been collected. Currently we are extending the YNTR by including siblings of twins. Participants in YNTR and ANTR have been phenotyped every 2 to 3 years in longitudinal survey studies, since 1986 and 1991 for the YNTR and ANTR, respectively. The resulting large population-based datasets are used for genetic epidemiological studies and also, for example, to advance phenotyping through the development of new syndrome scales based on existing items from other inventories. New research developments further include brain imaging studies in selected and unselected groups, clinical assessment of psychopathology through interviews, and cross-referencing the NTR database to other national databases. A large biobank enterprise is ongoing in the ANTR in which blood and urine samples are collected for genotyping, expression analysis, and meta-bolomics studies. In this paper we give an update on the YNTR and ANTR phenotyping and on the ongoing ANTR biobank studies.

Headache

2002 ◽  
Vol 12 (2) ◽  
pp. 127-144
Author(s):  
GJF Saldanha ◽  
CG Clough ◽  
N Ward
Keyword(s):  
General Population ◽  
Elderly Population ◽  
Large Population ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Population Based ◽  
Medical Attention ◽  
Population Based Study ◽  
The Usa ◽  
One Year

Little is known about the frequency of headache in the elderly population as few epidemiological studies have been carried out. In one year in the USA, 70% of the general population had a headache, 5% of whom sought medical attention. In a large population-based study carried out in East Boston, US, some 17% of patients over 65 yrs of age reported frequent headache, with 53% of women and 36% of men reporting headache in the previous year.

scholarly journals Ten-year trends in stroke admissions and outcomes in Canada

2015 ◽  
Vol 42 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Noreen Kamal ◽  
M. Patrice Lindsay ◽  
Robert Côté ◽  
Jiming Fang ◽  
Moira K. Kapral ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Age Groups ◽  
Population Based ◽  
Stroke Patients ◽  
Discharge Abstract Database ◽  
Absolute Increase ◽  
Admission Rates ◽  
Administrative Dataset ◽  
Hospital Administrative

AbstractBackgroundWe analyzed a 10-year stroke administrative dataset to examine trends in admissions, mortality, and discharge destination in Canada.MethodsWe conducted an analysis of hospital administrative data from April 1st 2003 to March 31st 2013 from the Canadian Institute of Health Information’s Discharge Abstract Database. Ten-year trends for population-based age- and sex-standardized admission rates were calculated. We reviewed 10-year trends in absolute stroke admissions for differences between provinces and age groups. Stroke 30-day in-hospital mortality rates were calculated and adjusted for sex, age, stroke type and comorbidities. We documented changes in discharge location for ischemic and hemorrhagic stroke patients discharged from acute care.ResultsThe rate of hospital admissions has declined from 140.2 to 117.5 (per 100,000 people). The number of absolute stroke admissions within provinces increased in Alberta and British Columbia (21.7% and 16.2% respectively). The proportion of stroke patients aged 40-69 years old increased by 4.8% (p<0.0001) over the 10 years, whereas the proportion aged over 70 decreased by 4.9% (p<0.0001). Risk-adjusted 30-day in-hospital mortality decreased from: 18.5% to 14.9% for all strokes; 15.2% to 12.1% for ischemic strokes; 35.6% to 29.7% for intracerebral hemorrhage; and 25.1% to 18.0% for subarachnoid hemorrhage. The absolute increase in patients requiring inpatient and outpatient support increased by 4% (p<0.0001).ConclusionThe rate of admissions for stroke is decreasing but there is an increase in stroke admissions for younger patients. In-hospital mortality is decreasing; fewer patients are going directly home without services and more are requiring support services.

Feasibility of Using Web-based Questionnaires in Large Population-based Epidemiological Studies

2006 ◽  
Vol 21 (2) ◽  
pp. 103-111 ◽  
Author(s):  
Alexandra Ekman ◽  
Paul W. Dickman ◽  
Åsa Klint ◽  
Elisabete Weiderpass ◽  
Jan-Eric Litton
Keyword(s):  
Large Population ◽  
Epidemiological Studies ◽  
Population Based ◽  
Web Based

Does Habitual Physical Activity Prevent Insomnia? A Cross-Sectional and Longitudinal Study of Elderly Japanese

2013 ◽  
Vol 21 (2) ◽  
pp. 119-139 ◽  
Author(s):  
Sachiko Inoue ◽  
Takashi Yorifuji ◽  
Masumi Sugiyama ◽  
Toshiki Ohta ◽  
Kazuko Ishikawa-Takata ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Frequency ◽  
Large Population ◽  
Epidemiological Studies ◽  
Population Based ◽  
Habitual Physical Activity ◽  
Protective Effects ◽  
Cross Sectional ◽  
Population Based Study ◽  
Elderly Japanese

Few epidemiological studies have examined the potential protective effects of physical activity on insomnia. The authors thus evaluated the association between physical activity and insomnia in a large population-based study in Shizuoka, Japan. Individual data were obtained from participants in an ongoing cohort study. A total of 14,001 older residents who completed questionnaires were followed for 3 yr. Of these, 10,211 and 3,697 participants were eligible for the cross-sectional and longitudinal analyses, respectively. The authors obtained information about the frequency of physical activity and insomnia. Then, the adjusted odds ratios and 95% confidence intervals between physical activity and insomnia were estimated. Habitual physical activity was related to lower prevalence of insomnia. Frequent physical activity also reduced the incidence of insomnia, especially difficulty maintaining sleep. For elderly people with sufficient mobility and no preexisting disease, high-frequency physical activity (e.g., 5 or more days/wk) may help reduce insomnia.

scholarly journals Utility of ICD Codes for Stress Cardiomyopathy in Hospital Administrative Databases: What Do They Signify?

2019 ◽  
pp. 160-163
Author(s):  
Anusha G Bhat ◽  
Kevin White ◽  
Kyle Gobeil ◽  
Tara Lagu ◽  
Peter K Lindenauer ◽  
...  
Keyword(s):  
Chart Review ◽  
Clinical Manifestations ◽  
International Classification Of Diseases ◽  
Stress Cardiomyopathy ◽  
Administrative Databases ◽  
Classification Of Diseases ◽  
Icd Codes ◽  
Hospital Administrative ◽  
New Diagnosis

Prior studies of stress cardiomyopathy (SCM) have used International Classification of Diseases (ICD) codes to identify patients in administrative databases without evaluating the validity of these codes. Between 2010 and 2016, we identified 592 patients discharged with a first known principal or secondary ICD code for SCM in our medical system. On chart review, 580 charts had a diagnosis of SCM (positive predictive value 98%; 95% CI: 96.4-98.8), although 38 (6.4%) did not have active clinical manifestations of SCM during the hospitalization. Moreover, only 66.8% underwent cardiac catheterization and 91.5% underwent echocardiography. These findings suggest that, although all but a few hospitalized patients with an ICD code for SCM had a diagnosis of SCM, some of these were chronic cases, and numerous patients with a new diagnosis of SCM did not undergo a complete diagnostic workup. Researchers should be mindful of these limitations in future studies involving administrative databases.

scholarly journals The Incidence of Hip Fractures in Long-Term Care Homes in Saskatchewan from 2008 to 2012: an Analysis of Provincial Administrative Databases

2017 ◽  
Vol 20 (3) ◽  
pp. 97-104 ◽  
Author(s):  
Lilian U. Thorpe ◽  
Susan J. Whiting ◽  
Wenbin Li ◽  
William Dust ◽  
Thomas Hadjistavropoulos ◽  
...  
Keyword(s):  
Long Term Care ◽  
Large Population ◽  
Age Groups ◽  
Epidemiological Data ◽  
Incidence Rates ◽  
Administrative Databases ◽  
Medium Size ◽  
Neck Of Femur ◽  
Term Care

BackgroundHip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics.MethodsWe utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur. HF incidence rates in LTC were compared to older adults in the general population.ResultsLTC residents were more likely to be female overall (65.5%), although this varied by age, with only 46.6% female in those under 65, but 77% female among those 90 years and older. Mean age of residents was highest in rural centres (85.2 yrs) and lowest in medium–large centres (81.0 yrs). Of 6,230 cases of HFs in the province during the study period, 2,743 (44%) were in the LTC cohort. Incidence rates per 1,000 person years increased with age and were higher in the LTC group (F = 68.6, M = 49.8) than the overall population (F = 1.62, M = 0.73). Rates of HFs in the province and in LTC were higher in females than males in all age groups, except for the youngest (< 65 years), where males had higher rates, and the oldest category (90+) where rates were similar. Women 90+ years in larger LTC had significantly higher (p = .035) HF rates than those in smaller LTC, and also had significantly (p = .001) higher rates in medium-large compared to smaller population centres. However, after age standardization to the overall SK population, it was apparent that the larger LTC facilities and the medium-large population centres had overall lower HF rates than the small and medium LTC facilities and the small urban and rural PCs, respectively. One health region had particularly high rates, even when accounting for age and sex composition.ConclusionBoth HF numbers and incidence rates were higher in LTC compared to the overall population, with higher rates in older women, small to medium size LTC, and particular health regions. Our data suggest the need for further exploration of potentially remediable factors for HFs in smaller LTCs, and for targeting specific facilities and regions with outlying HF rates.

scholarly journals Success Story of Targeted Therapy in Chronic Myeloid Leukemia: A Population-Based Study of Patients Diagnosed in Sweden From 1973 to 2008

2011 ◽  
Vol 29 (18) ◽  
pp. 2514-2520 ◽  
Author(s):  
Magnus Björkholm ◽  
Lotta Ohm ◽  
Sandra Eloranta ◽  
Åsa Derolf ◽  
Malin Hultcrantz ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitor ◽  
Large Population ◽  
Age Groups ◽  
Relative Survival ◽  
The Elderly ◽  
Population Based ◽  
Population Based Study ◽  
First Line Therapy

Purpose Chronic myeloid leukemia (CML) management changed dramatically with the development of imatinib mesylate (IM), the first tyrosine kinase inhibitor targeting the BCR-ABL1 oncoprotein. In Sweden, the drug was approved in November 2001. We report relative survival (RS) of patients with CML diagnosed during a 36-year period. Patients and Methods Using data from the population-based Swedish Cancer Registry and population life tables, we estimated RS for all patients diagnosed with CML from 1973 to 2008 (n = 3,173; 1,796 males and 1,377 females; median age, 62 years). Patients were categorized into five age groups and five calendar periods, the last being 2001 to 2008. Information on use of upfront IM was collected from the Swedish CML registry. Results Relative survival improved with each calendar period, with the greatest improvement between 1994-2000 and 2001-2008. Five-year cumulative relative survival ratios (95% Cls) were 0.21 (0.17 to 0.24) for patients diagnosed 1973-1979, 0.54 (0.50 to 0.58) for 1994-2000, and 0.80 (0.75 to 0.83) for 2001-2008. This improvement was confined to patients younger than 79 years of age. Five-year RSRs for patients diagnosed from 2001 to 2008 were 0.91 (95% CI, 0.85 to 0.94) and 0.25 (95% CI, 0.10 to 0.47) for patients younger than 50 and older than 79 years, respectively. Men had inferior outcome. Upfront overall use of IM increased from 40% (2002) to 84% (2006). Only 18% of patients older than 80 years of age received IM as first-line therapy. Conclusion This large population-based study shows a major improvement in outcome of patients with CML up to 79 years of age diagnosed from 2001 to 2008, mainly caused by an increasing use of IM. The elderly still have poorer outcome, partly because of a limited use of IM.

Abstract T P365: Childhood Stroke: ICD-9 Code Positive Predictive Values for Identifying Hemorrhagic and Ischemic Events

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Jane C Khoury ◽  
Kathleen Alwell ◽  
J, Michael Taylor ◽  
Heidi Sucharew ◽  
Charles J Moomaw ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Epidemiological Studies ◽  
Population Based ◽  
Incidence Rates ◽  
Administrative Databases ◽  
Childhood Stroke ◽  
Stroke Event ◽  
Primary Position ◽  
Predictive Values ◽  
Percent Correct

Introduction: Childhood stroke event rates have been reported both using administrative databases and population-based epidemiological studies. The latter include verification of stroke as a case and categorization of type. Administrative databases allow cheaper, quicker estimation of rates and possible extrapolation of estimated rates to population-based rates. However, these estimations rely on the accuracy and interpretation of the ICD-9 coding. Methods: The Greater Cincinnati/Northern Kentucky Stroke Study measures temporal trends in the incidence rates in a biracial population of 1.3 million. Discharge lists with primary and secondary ICD-9 codes 430-436 from 16 area hospitals for 2010 were obtained; 437-438, 674 and 747 were also included at the Children’s hospital. Detailed information from medical records of potential cases was abstracted by trained research nurses and reviewed by stroke physicians, who determined if the event was a case and, also the event type (hemorrhagic stroke, infarction or transient ischemic attack(TIA)). Results: A total of 89 potential events in children <20 years of age were reviewed, yielding 19 confirmed cases. Positive predictive values (PPV) for the primary ICD-9 codes for specific types varied from 0% to 100%. Primary and secondary ICD-9 codes, event types, and percent correct are presented in the Table. Conclusions: Childhood stroke cases captured through selected ICD-9 codes: 430-432, 434.x1, 434.9 and 435.9 (marked with an asterisk in the table) in the primary position would yield 14 strokes/TIAs, and underestimate the number of events by 26%. However, using both primary and secondary codes they would yield 34 strokes//TIAs, and overestimate the number of events by 79%. Population-based epidemiology studies are essential to monitor the validity of using ICD-9 codes to estimate childhood stroke/TIA incidence.

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