Rising prevalence of vascular comorbidities in multiple sclerosis: validation of administrative definitions for diabetes, hypertension, and hyperlipidemia

2012 ◽  
Vol 18 (9) ◽  
pp. 1310-1319 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Bo Nancy Yu ◽  
Stella Leung ◽  
Lawrence Elliott ◽  
Patricia Caetano ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Administrative Data ◽  
Medical Records ◽  
Temporal Trends ◽  
Prevalence Ratio ◽  
Hospital Physician ◽  
Case Definitions ◽  
General Population Cohort ◽  
General Populations

Background: Despite the importance of comorbidity in multiple sclerosis (MS), methods for comorbidity assessment in MS are poorly developed. Objective: We validated and applied administrative case definitions for diabetes, hypertension, and hyperlipidemia in MS. Methods: Using provincial administrative data we identified persons with MS and a matched general population cohort. Case definitions for diabetes, hypertension, and hyperlipidemia were derived using hospital, physician, and prescription claims, and validated in 430 persons with MS. We examined temporal trends in the age-adjusted prevalence of these conditions from 1984–2006. Results: Agreement between various case definitions and medical records ranged from kappa (κ) =0.51–0.69 for diabetes, κ =0.21–0.71 for hyperlipidemia, and κ =0.52–0.75 for hypertension. The 2005 age-adjusted prevalence of diabetes was similar in the MS (7.62%) and general populations (8.31%; prevalence ratio [PR] 0.91; 0.81–1.03). The age-adjusted prevalence did not differ for hypertension (MS: 20.8% versus general: 22.5% [PR 0.91; 0.78–1.06]), or hyperlipidemia (MS: 13.8% versus general: 15.2% [PR 0.90; 0.67–1.22]). The prevalence of all conditions rose in both populations over the study period. Conclusion: Administrative data are a valid means of tracking diabetes, hypertension, and hyperlipidemia in MS. The prevalence of these comorbidities is similar in the MS and general populations.

scholarly journals Incidence of malignancy in multiple sclerosis: A cohort study in the Danish Multiple Sclerosis Registry

2021 ◽  
Vol 7 (4) ◽  
pp. 205521732110539
Author(s):  
Mette Nørgaard ◽  
Katalin Veres ◽  
Finn T Sellebjerg ◽  
Lise S Svingel ◽  
Caroline Foch ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Skin Cancer ◽  
General Population ◽  
Incidence Rates ◽  
Disease Modifying Therapy ◽  
Non Melanoma Skin Cancer ◽  
General Population Cohort ◽  
Disease Modifying ◽  
Rate Ratios ◽  
Melanoma Skin

Background The association between multiple sclerosis and malignancy is controversial and a current appraisal is needed. Objective To determine the incidence of malignancy in patients with multiple sclerosis compared with the general population and in relation to disease-modifying therapy. Methods Patients with multiple sclerosis (1995 – 2015) were matched by birth year and sex to individuals without multiple sclerosis in the general population. Patients with multiple sclerosis initiating disease-modifying therapy were evaluated using landmark period analysis. Malignancy risk was assessed by incidence rates, incidence rate ratios, and standardised incidence ratios. Results The standardised incidence ratio of any malignancy (excluding non-melanoma skin cancer) in patients with multiple sclerosis ( n = 10,557) was 0.96 (95% CI 0.88 – 1.06), and there was no increased incidence of specific malignancy types compared with the general population cohort ( n = 103,761). At the 48-month landmark period, the age-adjusted incidence per 100,000 person-years of any malignancy (excluding non-melanoma skin cancer) was 436.7 (95% CI 361.0 – 512.4) in patients newly treated with immunomodulator-only and 675.1 (95% CI 130.4 – 1219.9) in patients newly treated with immunosuppressant-only. Conclusions There was no increased incidence of malignancy overall or by type in patients with multiple sclerosis compared neither with the general population nor in relation to disease-modifying therapy.

Cluster Headache in The Republic Of San Marino

Cephalalgia ◽  
1986 ◽  
Vol 6 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Roberto D'Alessandro ◽  
Gloria Gamberini ◽  
Giulia Benassi ◽  
Giovanni Morganti ◽  
Pietro Cortelli ◽  
...  
Keyword(s):  
General Population ◽  
Cluster Headache ◽  
Random Sample ◽  
Medical Records ◽  
Prevalence Ratio ◽  
Collection Method ◽  
The Past ◽  
Men 1 ◽  
The Republic ◽  
Case Collection

The prevalence of cluster headache (CH) in the Republic of San Marino (21,792 inhabitants; 10,893 men and 10,899 women) was studied, reviewing the past 15 years' medical records of neurological, ophthalmological, and otorhinolaryngological services. Further cases were searched for by means of a letter sent to each inhabitant. Control of the case collection method was performed on a random sample of 1314 inhabitants over 7 years, interviewed for possible past or present cluster headache. We found 15 cases of CH (14 men, 1 woman), for an estimated prevalence ratio of 69 cases per 100,000 population. No previous reports have been published on the prevalence of CH in the general population.

scholarly journals Performance of administrative case definitions for comorbidity in multiple sclerosis in Manitoba and Nova Scotia

2014 ◽  
Vol 34 (2/3) ◽  
pp. 145-153 ◽  
Author(s):  
RA Marrie ◽  
JD Fisk ◽  
KJ Stadnyk ◽  
H Tremlett ◽  
C Wolfson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Inflammatory Bowel Disease ◽  
Heart Disease ◽  
Nova Scotia ◽  
Administrative Data ◽  
Bowel Disease ◽  
Self Report ◽  
Comorbid Conditions ◽  
Case Definitions ◽  
Inflammatory Bowel

Introduction As the population ages and the prevalence of comorbid conditions increases, the need for feasible, validated methods of comorbidity surveillance in chronic diseases such as multiple sclerosis (MS) increases. Methods Using kappa (k) statistics, we evaluated the performance of administrative case definitions for comorbidities commonly observed in MS by comparing agreement between Manitoba (MB) administrative data and self-report (n = 606) and Nova Scotia (NS) administrative data and self-report (n = 1923). Results Agreement between the administrative definitions and self-report was substantial for hypertension (k = 0.69 [NS], 0.76 [MB]) and diabetes (k = 0.70 [NS], 0.66 [MB]); moderate for hyperlipidemia (k = 0.53 [NS], 0.51 [MB]) and heart disease (k = 0.42 [NS], 0.51 [MB]) and fair for anxiety (k = 0.27 [NS], 0.26 [MB]). In NS, agreement was substantial for inflammatory bowel disease (k = 0.71) and moderate for epilepsy (k = 0.48). Conclusion Administrative definitions for commonly observed comorbidities in MS performed well in 2 distinct jurisdictions. This suggests that they could be used more broadly across Canada and in national studies.

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.

Physical Disease and Disability among 416 Suicide Cases in Sweden

1988 ◽  
Vol 16 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Richard Stensman ◽  
Ulla-Britt Sundqvist-Stensman
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
General Population ◽  
Medical Care ◽  
Suicide Rate ◽  
Medical Records ◽  
Malignant Neoplasm ◽  
High Suicide Rate ◽  
Somatic Disease ◽  
Very High

All suicides occurring among the inhabitants of the County of Uppsala in Sweden between 1977 and 1984 were analyzed on the basis of information from autopsy reports and from somatic and psychiatric medical records. Among the 416 persons who committed suicide, 70 (17%) had a somatic disease of probable importance for the suicidal act. No somatic diagnosis appeared to stand out as being especially associated with a very high risk of suicide. Some diagnoses (e.g. malignant neoplasm, Parkinson's disease, multiple sclerosis) were, however, associated with a suicidal rate above that in the general population. Further knowledge about the relation between suicide and specific somatic diagnoses would be of value, since a high suicide rate in association with a particular illness might indicate insufficient medical care and rehabilitation.

scholarly journals The Incidence and Prevalence of Thyroid Disease Do Not Differ in the Multiple Sclerosis and General Populations: A Validation Study Using Administrative Data

2012 ◽  
Vol 39 (2) ◽  
pp. 135-142 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Bo Nancy Yu ◽  
Stella Leung ◽  
Lawrence Elliott ◽  
Sharon Warren ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Administrative Data ◽  
Validation Study ◽  
Thyroid Disease ◽  
General Populations

scholarly journals Identifying Cases of Sleep Disorders through International Classification of Diseases (ICD) Codes in Administrative Data

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Rachel J Jolley ◽  
Zhiying Liang ◽  
Mingkai Peng ◽  
Sachin R Pendharkar ◽  
Willis Tsai ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Ambulatory Care ◽  
Sleep Disorder ◽  
Administrative Data ◽  
Medical Records ◽  
Claims Data ◽  
Clinic Visit ◽  
Reference Standard ◽  
Case Definitions ◽  
Icd Codes

Objectives Prevalence, and associated morbidity and mortality of chronic sleep disorders have been limited to small cohort studies, however, administrative data may be used to provide representation of larger population estimates of disease. With no guidelines to inform the identification of cases of sleep disorders in administrative data, the objective of this study was to develop and validate a set of ICD-codes used to define sleep disorders including narcolepsy, insomnia, and obstructive sleep apnea (OSA) in administrative data. Methods A cohort of adult patients, with medical records reviewed by two independent board-certified sleep physicians from a sleep clinic in Calgary, Alberta between January 1, 2009 and December 31, 2011, was used as the reference standard. We developed a general ICD-coded case definition for sleep disorders which included conditions of narcolepsy, insomnia, and OSA using: 1) physician claims data, 2) inpatient visit data, 3) emergency department (ED) and ambulatory care data. We linked the reference standard data and administrative data to examine the validity of different case definitions, calculating estimates of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).  Results From a total of 1186 patients from the sleep clinic, 1045 (88.1%) were classified as sleep disorder positive, with 606 (51.1%) diagnosed with OSA, 407 (34.4%) with insomnia, and 59 (5.0%) with narcolepsy. The most frequently used ICD-9 codes were general codes of 307.4 (Nonorganic sleep disorder, unspecified), 780.5 (unspecified sleep disturbance) and ICD-10 codes of G47.8 (other sleep disorders), G47.9 (sleep disorder, unspecified). The best definition for identifying a sleep disorder was an ICD code (from physician claims) 2 years prior and 1 year post sleep clinic visit: sensitivity 79.2%, specificity 28.4%, PPV 89.1%, and NPV 15.6%. ICD codes from ED/ambulatory care data provided similar diagnostic performance when at least 2 codes appeared in a time period of 2 years prior and 1 year post sleep clinic visit: sensitivity 71.9%, specificity 54.6%, PPV 92.1%, and NPV 20.8%. The inpatient data yielded poor results in all tested ICD code combinations. Conclusion Sleep disorders in administrative data can be identified mainly through physician claims data and with some being determined through outpatient/ambulatory care data ICD codes, however these are poorly coded within inpatient data sources. This may be a function of how sleep disorders are diagnosed and/or reported by physicians in inpatient and outpatient settings within medical records. Future work to optimize administrative data case definitions through data linkage are needed.

Development and validation of an administrative data algorithm to estimate the disease burden and epidemiology of multiple sclerosis in Ontario, Canada

2014 ◽  
Vol 21 (8) ◽  
pp. 1045-1054 ◽  
Author(s):  
Jessica Widdifield ◽  
Noah M Ivers ◽  
Jacqueline Young ◽  
Diane Green ◽  
Liisa Jaakkimainen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Administrative Data ◽  
Medical Records ◽  
Disease Burden ◽  
Search Strategy ◽  
High Sensitivity ◽  
Incidence Rates ◽  
Development And Validation ◽  
Over Time ◽  
Age And Sex

Background: Few studies have assessed the accuracy of administrative data for identifying multiple sclerosis (MS) patients. Objectives: To validate administrative data algorithms for MS, and describe the burden and epidemiology over time in Ontario, Canada. Methods: We employed a validated search strategy to identify all MS patients within electronic medical records, to identify patients with and without MS (reference standard). We then developed and validated different combinations of administrative data for algorithms. The most accurate algorithm was used to estimate the burden and epidemiology of MS over time. Results: The accuracy of the algorithm of one hospitalisation or five physician billings over 2 years provided both high sensitivity (84%) and positive predictive value (86%). Application of this algorithm to provincial data demonstrated an increasing cumulative burden of MS, from 13,326 patients (0.14%) in 2000 to 24,647 patients in 2010 (0.22%). Age-and-sex standardised prevalence increased from 133.9 to 207.3 MS patients per 100,000 persons in the population, from 2000 – 2010. During this same period, age-and-sex-standardised incidence varied from 17.9 to 19.4 patients per 100,000 persons. Conclusions: MS patients can be accurately identified from administrative data. Our findings illustrated a rising prevalence of MS over time. MS incidence rates also appear to be rising since 2009.

Psychometric Properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C)

2012 ◽  
Vol 28 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Anna Ogliari ◽  
Simona Scaini ◽  
Michael J. Kofler ◽  
Valentina Lampis ◽  
Annalisa Zanoni ◽  
...  
Keyword(s):  
General Population ◽  
Social Phobia ◽  
Psychometric Properties ◽  
Emotional Disorders ◽  
Child Anxiety ◽  
Self Report ◽  
Public Performance ◽  
Confirmatory Factor Analyses ◽  
The Social ◽  
General Populations

Reliable and valid self-report questionnaires could be useful as initial screening instruments for social phobia in both clinical settings and general populations. The present study investigates the factor structure and psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C) in a sample of 228 children from the Italian general population aged 8 to 11. The children were asked to complete the Italian version of the SPAI-C and the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire. Confirmatory factor analyses revealed that social phobia can be conceptualized as a unitary construct consisting of five distinct but interrelated symptom clusters named Assertiveness, General Conversation, Physical/Cognitive Symptoms, Avoidance, and Public Performance. Internal consistency of the SPAI-C total scores and two subscales was good; correlations between SPAI-C total scores and SCARED total scores/subscales ranged from moderate to high (Generalized Anxiety Disorder, for social phobia), with the SCARED Social Phobia subscale as the best predictor of SPAI-C total scores. The results indicate that the SPAI-C is a reliable and sensitive instrument suitable for identifying Social Phobia in the young Italian general population.

Factor Structure and Measurement Invariance of the Obsessive-Compulsive Inventory – Child Version (OCI-CV) in General Population

2017 ◽  
Vol 33 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Tíscar Rodríguez-Jiménez ◽  
Antonio Godoy ◽  
José A. Piqueras ◽  
Aurora Gavino ◽  
Agustín E. Martínez-González ◽  
...  
Keyword(s):  
General Population ◽  
Children And Adolescents ◽  
Factor Structure ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Good Consistency ◽  
Order Factor ◽  
General Populations ◽  
Report Measure

Abstract. Evidence-based assessment is necessary as a first step for developing psychopathological studies and assessing the effectiveness of empirically validated treatments. There are several measures of obsessive-compulsive disorder (OCD) and/or symptomatology in children and adolescents, but all of them present some limitations. The Obsessive-Compulsive Inventory-Revised (OCI-R) by Foa and her colleagues has showed to be a good self-report measure to capture the dimensionality of OCD in adults and adolescents. The child version of the OCI (OCI-CV) was validated for clinical children and adolescents in 2010, showing excellent psychometric properties. The objective of this study was to examine the factor structure and invariance of the OCI-CV in the general population. Results showed a six-factor structure with one second-order factor, good consistency values, and invariance across region, age, and sex. The OCI-CV is an excellent inventory for assessing the dimensions of OCD symptomatology in general populations of children and adolescents. The invariance across sex and age warrants its utilization for research purposes.

Sign in / Sign up

Export Citation Format

Share Document