Predictive value of stroke discharge diagnoses in the Danish National Patient Register

2017 ◽  
Vol 45 (6) ◽  
pp. 630-636 ◽  
Author(s):  
Pernille Lühdorf ◽  
Kim Overvad ◽  
Erik B. Schmidt ◽  
Søren P. Johnsen ◽  
Flemming W. Bach
Keyword(s):  
Predictive Value ◽  
Medical Records ◽  
Outpatient Clinics ◽  
Discharge Diagnosis ◽  
Predictive Values ◽  
National Patient Register ◽  
Patient Register ◽  
Stroke Diagnosis ◽  
National Patient ◽  
Danish National Patient Register

Aims: To determine the positive predictive values for stroke discharge diagnoses, including subarachnoidal haemorrhage, intracerebral haemorrhage and cerebral infarction in the Danish National Patient Register. Methods: Participants in the Danish cohort study Diet, Cancer and Health with a stroke discharge diagnosis in the National Patient Register between 1993 and 2009 were identified and their medical records were retrieved for validation of the diagnoses. Results: A total of 3326 records of possible cases of stroke were reviewed. The overall positive predictive value for stroke was 69.3% (95% confidence interval (CI) 67.8–70.9%). The predictive values differed according to hospital characteristics, with the highest predictive value of 87.8% (95% CI 85.5–90.1%) found in departments of neurology and the lowest predictive value of 43.0% (95% CI 37.6–48.5%) found in outpatient clinics. Conclusions: The overall stroke diagnosis in the Danish National Patient Register had a limited predictive value. We therefore recommend the critical use of non-validated register data for research on stroke. The possibility of optimising the predictive values based on more advanced algorithms should be considered.

Validity of the diagnosis of appendicitis in the Danish National Patient Register

2018 ◽  
Vol 48 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Jakob Kleif ◽  
Lau C. Thygesen ◽  
Ismail Gögenur
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Surgical Removal ◽  
Predictive Values ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Sensitivity Specificity ◽  
Danish National Patient Register

Aims: Appendicitis is a common disease. The nationwide Danish National Patient Register provides an important data source for epidemiological research. Data used in register-based epidemiological research needs to be validated. We aimed to validate the diagnosis of appendicitis in the Danish National Patient Register. Methods: From 1997 to 2015 nationwide data from the Danish National Patient Register, the Danish Pathology Register, and the Danish Civil Registration System were used to validate the diagnosis of appendicitis or the combination of the diagnosis for appendicitis and surgical removal of the appendix in the Danish National Patient Register. Sensitivity, specificity, and positive and negative predictive values were calculated using pathology reports as golden standard. Results: Diagnosis of appendicitis in the Danish National Patient Register had a sensitivity, specificity, positive predictive value, and negative predictive value of 0.928 (95% confidence interval (CI): 0.927; 0.930), 0.995 (95% CI: 0.995; 0.995), 0.769 (95% CI: 0.767; 0.771), and 0.999 (95% CI: 0.999; 0.999). A diagnosis of appendicitis and a procedure code for surgical removal of the appendix had a sensitivity, specificity, positive predictive value, and negative predictive value of 0.886 (95% CI: 0.885; 0.888), 0.998 (95% CI: 0.998; 0.998), 0.895 (95% CI: 0.894; 0.897), and 0.998 (95% CI: 0.998; 0.998). Conclusions: The diagnosis of appendicitis alone or in combination with the registered surgical removal of the appendix in the Danish National Patient Register showed acceptable validity. Whether to use the diagnosis for appendicitis only or in combination with procedure codes for the removal of the appendix depends on whether high sensitivity or high positive predictive values are warranted.

The use of hospitalizations by persistent somatizing patients

1992 ◽  
Vol 22 (1) ◽  
pp. 173-180 ◽  
Author(s):  
Per Fink
Keyword(s):  
General Population ◽  
General Hospital ◽  
Medical Records ◽  
Physical Symptoms ◽  
Organic Basis ◽  
General Hospitals ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Danish National Patient Register

SYNOPSISMedical records were selected from the Danish National Patient Register in order to study individuals between the ages of 17 and 49 years in the general population who, during an 8-year period, were admitted at least 10 times to a general hospital (N = 282). Fifty-six subjects (19%) were found to be persistent somatizers, i.e. they were admitted repeatedly to general hospitals for physical symptoms without an organic basis. This corresponded to a frequency of persistent somatization in the population 0·6 per 1000 men and 3·2 per 1000 women.

scholarly journals Pediatric acquired demyelinating syndromes: a nationwide validation study of the Danish National Patient Register

2018 ◽  
Vol Volume 10 ◽  
pp. 391-399 ◽  
Author(s):  
Magnus Spangsberg Boesen ◽  
Melinda Magyari ◽  
Alfred Born ◽  
Lau Caspar Thygesen
Keyword(s):  
Validation Study ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Danish National Patient Register

scholarly journals Moving from an era of open Appendectomy to an era of Laparoscopic Appendectomy: A Nationwide Cohort Study of Adult Patients Undergoing Surgery for Appendicitis

2021 ◽  
pp. 145749692199261
Author(s):  
J. Kleif ◽  
L. C. Thygesen ◽  
I. Gögenur
Keyword(s):  
Laparoscopic Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Surgery ◽  
Adult Patients ◽  
Registration System ◽  
Postoperative Stay ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Danish National Patient Register

Background and Aims: During the last decades, laparoscopic surgery has been introduced as an alternative to open surgery. We aimed to examine to what extent laparoscopic surgery has replaced open surgery for appendicitis in an entire nation during the last two decades. Second, we examined the effects of shifting to laparoscopic surgery for appendicitis on different quality indicators such as length of postoperative stay and mortality. We also examined age as a predictor of 30-day mortality. Materials and Methods: During the period 2000 to 2015, all adult patients with appendicitis and surgical removal of the appendix were identified in the Danish National Patient Register. Demographics, type of surgery, time of surgery, and duration of postoperative stay were retrieved form Danish National Patient Register. Vital status was retrieved from the Danish Civil Registration System. Results: A total of 58,093 patients underwent surgery for appendicitis. In 2000, a total of 274 out of 3717 (7.4%) had a laparoscopic appendectomy, and the postoperative stay was 55 (iqr: 35–88) h and 30-day mortality was 0.91%. In 2015, a total of 3995 out of 4296 (93.0%) had a laparoscopic appendectomy, and the postoperative stay was 16 (iqr: 9–56) h and 30-day mortality was 0.40%. Age as a predictor of 30-day postoperative mortality had an area under the curve of 0.93 (95% confidence interval: 0.92; 0.94). Conclusion: In Denmark, the standard surgical procedure for appendicitis has changed from open surgery to laparoscopic surgery during the period 2000–2015. At the same time, duration of postoperative stay and 30-day mortality has decreased.

scholarly journals Validity and reliability of social anxiety disorder diagnoses in the Swedish National Patient Register

2019 ◽  
Author(s):  
Alba Vilaplana-Pérez ◽  
Josef Isung ◽  
Sonja Matu Marjatta Krig ◽  
Sarah Vigerland ◽  
Maral Jolstedt ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Rater Agreement ◽  
Predictive Values ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Icd 10 ◽  
The Impact

BACKGROUND: Population-based administrative registers are often used for research purposes. However, their potential usefulness depends on the validity of the registered information. This study assessed the validity of the recorded codes for social anxiety disorder (SAD) in the Swedish National Patient Register (NPR). METHODS: The personal identification numbers of 300 randomly selected individuals with a diagnosis of SAD (also known as social phobia) recorded in the NPR were obtained from the Swedish National Board of Health and Welfare. The medical files of these individuals were then requested from clinics nationally. A total of 117 files were received and two independent raters reviewed each file to assess the presence or absence of SAD, according to the definition of the International Classification of Diseases, Tenth Edition (ICD-10) and the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). When disagreements between the two raters were found, a third rater reviewed the file to establish a best estimate diagnosis. Positive predictive values (PPV) and agreement between the two initial raters (using Cohen’s kappa) were calculated. Additionally, raters completed the Clinical Global Impression – Severity (CGI-S) and the Global Assessment of Functioning (GAF) rating scales for each file. Inter-rater agreement for the CGI-S and the GAF was assessed using intraclass correlation coefficients (ICC).RESULTS: After exclusion of files not comprising sufficient information, 95 files were included in the analyses. Of these, 77 files (81.05%) were considered to be ‘true positive’ cases. This resulted in a PPV of 0.81 (95% confidence interval, 0.72-0.88). Inter-rater agreement regarding the presence or absence of SAD was substantial (κ=0.72). CGI-S and GAF scores indicated that patients were in the moderate range of severity and functional impairment. Inter-rater agreement for the CGI-S and the GAF was moderate to good (ICC=0.72 and ICC=0.82, respectively). CONCLUSIONS: The ICD-10 codes for SAD in the Swedish NPR are generally valid and reliable, but we recommend sensitivity analyses in future register-based studies to minimise the impact of potential diagnostic misclassification. Most patients were moderately severe and impaired, suggesting that results from register-based studies of SAD may be generalizable.

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