scholarly journals Validation of Carotid Artery Revascularization Coding in Ontario Health Administrative Databases

2016 ◽  
Vol 39 (2) ◽  
pp. 73 ◽  
Author(s):  
Mohamad A Hussain ◽  
Muhammad Mamdani ◽  
Gustavo Saposnik ◽  
Jack V Tu ◽  
David Turkel-Parrella ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Administrative Data ◽  
High Volume ◽  
Population Based ◽  
Administrative Databases ◽  
Ontario Health Insurance Plan ◽  
Stroke Registry ◽  
Administrative Records ◽  
Ischemic Attack ◽  
Procedure Codes

Purpose: The positive predictive value (PPV) of carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedure and post-operative complication coding were assessed in Ontario health administrative databases. Methods: Between 1 April 2002 and 31 March 2014, a random sample of 428 patients were identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. A blinded chart review was conducted at two high-volume vascular centers to assess the level of agreement between the administrative records and the corresponding patients’ hospital charts. PPV was calculated with 95% confidence intervals (CIs) to estimate the validity of CEA and CAS coding, utilizing hospital charts as the gold standard. Sensitivity of CEA and CAS coding were also assessed by linking two independent databases of 540 CEA-treated patients (Ontario Stroke Registry) and 140 CAS-treated patients (single-center CAS database) to administrative records. Results: PPV for CEA ranged from 99% to 100% and sensitivity ranged from 81.5% to 89.6% using CCI and OHIP codes. A CCI code with a PPV of 87% (95% CI, 78.8-92.9) and sensitivity of 92.9% (95% CI, 87.4-96.1) in identifying CAS was also identified. PPV for post-admission complication diagnosis coding was 71.4% (95% CI, 53.7-85.4) for stroke/transient ischemic attack, and 82.4% (95% CI, 56.6-96.2) for myocardial infarction. Conclusions: Our analysis demonstrated that the codes used in administrative databases accurately identify CEA and CAS-treated patients. Researchers can confidently use administrative data to conduct population-based studies of CEA and CAS.

scholarly journals Validation of endovascular and open thoracoabdominal aortic aneurysm repair in Ontario health administrative databases

2019 ◽  
Vol 42 (2) ◽  
pp. E19-25 ◽  
Author(s):  
Rodolfo V. Rocha ◽  
Mohammed Al-Omran ◽  
Mohamad A. Hussain ◽  
Douglas S. Lee ◽  
Thomas L. Forbes ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Administrative Data ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Population Based ◽  
Administrative Databases ◽  
Ontario Health Insurance Plan ◽  
Administrative Records ◽  
Thoracoabdominal Aortic Aneurysm Repair ◽  
Aneurysm Repair ◽  
Procedure Codes

Purpose: The positive predictive value (PPV) of endovascular and open thoracoabdominal aortic aneurysm (TAAA) repair coding was assessed in Ontario health administrative databases. Methods: Between 1 January 2006 and 31 March 2016, a random sample of 192 patients was identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. Blinded chart reviews were conducted at two cardiovascular centers to assess the level of agreement between the administrative records and the corresponding patients’ hospital charts. The PPV was calculated with 95% confidence intervals using hospital charts as the gold standard. Results: The PPV for the single endovascular TAAA repair code, 1ID80GQNRN, was 0.90 (0.78, 0.97). A combination of all nine CCI open TAAA repair codes was performed, with a PPV of 0.62 (0.47, 0.76). The combination of any one of the nine CCI codes AND the single OHIP code for open TAAA repair (R803) rendered a PPV of 0.98 (0.90, 1.00). Conclusions: Endovascular TAAA repair may be identified using a single CCI code (1ID80GQNRN). Open TAAA repair may be identified using a combination of CCI and OHIP codes. Researchers may therefore use administrative data to conduct population-based studies of endovascular and open repair of TAAA.

Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study

2021 ◽  
Vol 184 (1) ◽  
pp. 19-28
Author(s):  
Alexander A Leung ◽  
Janice L Pasieka ◽  
Martin D Hyrcza ◽  
Danièle Pacaud ◽  
Yuan Dong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Administrative Data ◽  
Laboratory Data ◽  
Population Based ◽  
Incidence Rates ◽  
Primary Objective ◽  
Administrative Databases ◽  
Secondary Objective ◽  
True Frequency ◽  
Clinical Records

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.

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

2016 ◽  
Vol 43 (6) ◽  
pp. 765-773 ◽  
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.

scholarly journals Access to cancer care in northwestern Ontario—a population-based study using administrative data

2020 ◽  
Vol 27 (3) ◽  
Author(s):  
M. Febbraro ◽  
M. Conlon ◽  
J. Caswell ◽  
N. Laferriere
Keyword(s):  
Administrative Data ◽  
Urban Areas ◽  
Access To Health Care ◽  
Universal Access ◽  
Population Based ◽  
Ontario Health Insurance Plan ◽  
Cancer Data ◽  
Factors Associated ◽  
Specialist Consultation ◽  
Northwestern Ontario

Background: Despite universal access to health care in Canada, disparities exist relating to social determinants of health, which contribute to discrepancies in cancer incidence and outcomes between rural and urban areas. Given that Canada has one of the highest-quality national population-based cancer registry systems in the world and there is little information regarding cancer statistics specific to northwestern Ontario, the purpose of this study was to estimate the percentage of cancer patients without documentation of a specialist consultation (medical or radiation oncology consultation) and to determine factors that affect access to specialist consultation in northwestern Ontario. Methods: This was a population-based retrospective study using administrative data. Administration data was obtained through the Ontario Cancer Data Linkage Project. For each index case, a timeline was constructed of all Ontario Health Insurance Plan billing codes and associated service dates starting with primary cancer diagnosis and ending with death. Specific factors affecting access to specialist consultation were assessed. Results: Within the 6 year study period (2010-2016), 2583 index cases were identified. Most (n=2007, 78%) received a specialist consultation. Factors associated with not receiving a specialist consultation included older age (p<0.0001, OR 0.29; 95% CI 0.19-0.44) and rural residence (p<0.0001, OR 0.48; 95% CI 0.48-0.72). Factors associated with receiving a specialist consultation included increased duration of disease (p< 0.0001, OR 1.32; 95% CI 1.19-1.46), a diagnosis of breast cancer (p < 0.0001, OR 2.51; 95% CI 1.43-4.42), and a diagnosis of lung cancer (p< 0.0001, OR 1.77; 95% CI 1.38-2.26).   Conclusions: These findings are consistent with the other studies assessing access to care barriers, but is the first to look at care access in northwestern Ontario. Further research is needed to examine gaps in care relating to access to primary referral services, symptom recognition, cancer screening, and travel associated burdens specific to northwestern Ontario.

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.

Quality indicators for end-of-life breast cancer care: Testing the use of administrative databases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6066-6066 ◽  
Author(s):  
L. Lethbridge ◽  
E. Grunfeld ◽  
R. Dewar ◽  
G. Johnston ◽  
P. McIntyre ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
End Of Life ◽  
Administrative Data ◽  
Population Based ◽  
Vital Statistics ◽  
Administrative Databases ◽  
Breast Cancer Patients ◽  
Eol Care

6066 Background: Defining, measuring and monitoring quality of care is a facet of health services research that is growing in importance. Breast cancer offers a disease model to examine quality end-of-life (EOL) care provided to women. Administrative data have the unique potential to provide population-based measures of quality of care. The objective of this study was to assess the feasibility of using routinely-collected administrative data to measure quality EOL care for breast cancer patients. Methods: A cohort of all women in Nova Scotia who died of breast cancer between 01/01/1998 and 31/12/2002 was assembled from the Cancer Registry and Vital Statistics data. The EOL study period was defined as the last 6 months of life. A total of 864 women met the eligibility criteria. After a literature review, an expert panel identified 19 indicators that were potentially measurable through administrative data. Physician billings, hospital discharge abstracts and seniors pharmacare data, supplemented by clinical datasets, were utilized to calculate the statistics with which to represent the indicators. Results: Benchmark measures of care across the cohort show 63.4% died in a hospital, a mean continuity of care index of 0.786, and the mean number of inpatient days in the last 30 was 9.9. Indicators of aggressive care include 9.3% had chemotherapy in the last 14 days, 5.6% had more than 1 emergency room visit in the last 30 days, and 29.1% had more than 14 inpatient days in the last 30 days. Conclusions: Weaknesses of using these data include: 1) fixed variables with an administrative rather than a clinical objective; 2) lack of comprehensiveness of various datasets; and 3) the use of billings data where increasingly physicians are paid through methods other than fee-for-service. Strengths of this approach are: 1) population-based cohort; 2) comprehensiveness of cohort selection through the provincial Vital Statistics file; and 3) accessibility of data. No significant financial relationships to disclose.

The validity of algorithms using health administrative data in identifying cancer-related events in adolescents and young adults: A population-based study using the IMPACT cohort.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18168-e18168
Author(s):  
Jason D Pole ◽  
Paul C. Nathan ◽  
Nancy N. Baxter ◽  
Cindy Lau ◽  
Corinne Daly ◽  
...  
Keyword(s):  
Young Adults ◽  
Administrative Data ◽  
Population Based ◽  
Adolescents And Young Adults ◽  
Administrative Databases ◽  
Time Interval ◽  
Cancer Outcomes ◽  
Health Administrative Data ◽  
Chart Abstraction ◽  
The Impact

e18168 Background: Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse and progression. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults (AYA) with cancer. Methods: We identified all Ontario AYA 15-21 years of age diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992 and 2012. Chart abstraction was used to determine the end of initial treatment (EOIT) date and subsequent cancer-related events (progression, relapse, second cancer). Linkage to population-based administrative databases identified fee and procedure codes indicating cancer treatment or palliative care. Algorithms that determined EOIT based a time interval free of treatment-associated codes, and new cancer-related events based on billing codes, were compared to chart abstracted data. Results: The cohort comprised 1,404 patients. Time periods free of treatment-associated codes did not validly identify EOIT dates; using subsequent codes to identify new cancer events was thus associated with low sensitivity (56.2%). However, using administrative data codes that occurred after the EOIT date based on chart abstraction, the first cancer-related event was identified with excellent validity (sensitivity 87.0%, specificity 93.3%, PPV 81.5%, negative predictive value 95.5%). Conclusions: While administrative data alone did not validly identify cancer-related events, using administrative data in combination with chart collected EOIT dates was associated with excellent validity. The collection of EOIT dates by cancer registries would significantly expand the potential of administrative data linkage to assess cancer outcomes.

Determining the cancer diagnostic interval using administrative data in a cohort of patients with pancreatic ductal adenocarcinoma (PDAC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13551-e13551
Author(s):  
Bailey Paterson ◽  
Shiying Kong ◽  
Alyson Mahar ◽  
Colleen Webber ◽  
Richard M. Lee-Ying ◽  
...  
Keyword(s):  
Administrative Data ◽  
Control Charts ◽  
Population Based ◽  
Administrative Databases ◽  
Interval Length ◽  
Ductal Adenocarcinoma ◽  
Statistical Control ◽  
Wide Range ◽  
Age Of Diagnosis ◽  
Diagnostic Interval

e13551 Background: PDAC is a leading cause of cancer death that is often diagnosed at an advanced stage. Population-based administrative data can be a valuable resource for studying the diagnostic interval, defined as the time from the first related healthcare encounter to cancer diagnosis. The objective of this study was to determine the diagnostic interval in a cohort of patients with PDAC using an empirical approach. Methods: This is a retrospective, cohort study of patients diagnosed with PDAC from 2007 – 2015 in Alberta, Canada. We used the Alberta Cancer Registry, physician billing claims, hospital discharge and emergency room visits to identify and categorize cancer-related healthcare encounters before diagnosis. We used statistical control charts to define the lookback period for each encounter category and used these lookback periods to identify the earliest encounter that represented the start of the diagnostic interval (index contact date). The end of the interval was the diagnosis date. Quantile regression was used to determine factors associated with the diagnostic interval. Results: We identified 3,142 patients with PDAC. Median age of diagnosis was 71 (IQR 61-80). We identified an index contact date and thus a diagnostic interval in 96.5% of patients. The median diagnostic interval length was 76 days (IQR 21-191; 90th percentile 276 days). A higher Elixhauser comorbidity score (+18.57 days/ 1 point increase, 95% CI 16.07-21.07, p<0.001) and stage 3 disease compared to stage 2 disease (+22.55 days, 95% CI 5.02-40.08, p=0.01) were associated with a longer diagnostic interval. Conclusions: In this cohort of patients with PDAC, there was a wide range in the diagnostic interval with 10% of patients having a diagnostic interval of approximately 9 months. Diagnostic interval research using administrative databases can understand variations in diagnosis times and can inform early detection efforts by identifying where and in whom delays may occur.

scholarly journals Decrease in Hospital Admissions for Transient Ischemic Attack, Mild, and Moderate Stroke During the COVID-19 Era

Stroke ◽  
2020 ◽  
Vol 51 (8) ◽  
pp. 2315-2321 ◽  
Author(s):  
Henrique Diegoli ◽  
Pedro S.C. Magalhães ◽  
Sheila C.O. Martins ◽  
Carla H.C. Moro ◽  
Paulo H.C. França ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Statistical Tests ◽  
Stroke Care ◽  
Population Based ◽  
Public Authorities ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Before And After ◽  
Ischemic Attack ◽  
The Impact

Background and Purpose: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, doctors and public authorities have demonstrated concern about the reduction in quality of care for other health conditions due to social restrictions and lack of resources. Using a population-based stroke registry, we investigated the impact of the onset of the COVID-19 pandemic in stroke admissions in Joinville, Brazil. Methods: Patients admitted after the onset of COVID-19 restrictions in the city (defined as March 17, 2020) were compared with those admitted in 2019. We analyzed differences between stroke incidence, types, severity, reperfusion therapies, and time from stroke onset to admission. Statistical tests were also performed to compare the 30 days before and after COVID-19 to the same period in 2019. Results: We observed a decrease in total stroke admissions from an average of 12.9/100 000 per month in 2019 to 8.3 after COVID-19 ( P =0.0029). When compared with the same period in 2019, there was a 36.4% reduction in stroke admissions. There was no difference in admissions for severe stroke (National Institutes of Health Stroke Scale score >8), intraparenchymal hemorrhage, and subarachnoid hemorrhage. Conclusions: The onset of COVID-19 was correlated with a reduction in admissions for transient, mild, and moderate strokes. Given the need to prevent the worsening of symptoms and the occurrence of medical complications in these groups, a reorganization of the stroke-care networks is necessary to reduce collateral damage caused by COVID-19.

scholarly journals Validation of Coding Algorithms for the Identification of Patients with Primary Biliary Cirrhosis Using Administrative Data

2010 ◽  
Vol 24 (3) ◽  
pp. 175-182 ◽  
Author(s):  
Robert P Myers ◽  
Abdel Aziz M Shaheen ◽  
Andrew Fong ◽  
Alex F Wan ◽  
Mark G Swain ◽  
...  
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Administrative Data ◽  
Large Scale ◽  
Optimal Algorithm ◽  
Epidemiological Studies ◽  
Population Based ◽  
Sensitivity Analyses ◽  
Administrative Databases ◽  
Biliary Cirrhosis ◽  
Predictive Values

BACKGROUND: Large-scale epidemiological studies of primary biliary cirrhosis (PBC) have been hindered by difficulties in case ascertainment.OBJECTIVE: To develop coding algorithms for identifying PBC patients using administrative data – a widely available data source.METHODS: Population-based administrative databases were used to identify patients with a diagnosis code for PBC from 1994 to 2002. Coding algorithms for confirmed PBC (two or more of antimitochondrial antibody positivity, cholestatic liver biochemistry and/or compatible liver histology) were derived using chart abstraction data as the reference. Patients with a recorded PBC diagnosis but insufficient confirmatory data were classified as ‘suspected PBC’.RESULTS: Of 189 potential PBC cases, 119 (60%) had confirmed PBC and 28 (14%) had suspected PBC. The optimal algorithm including two or more uses of a PBC code had a sensitivity of 94% (95% CI 71% to 100%) and positive predictive values of 73% (95% CI 61% to 75%) for confirmed PBC, and 89% (95% CI 82% to 94%) for confirmed or suspected PBC. Sensitivity analyses revealed greater accuracy among women, and with the use of multiple data sources and one or more years of data. Inclusion of diagnosis codes for conditions frequently misclassified as PBC did not improve algorithm performance.CONCLUSIONS: Administrative databases can reliably identify patients with PBC and may facilitate epidemiological investigations of this condition.

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