The rising prevalence and changing age distribution of multiple sclerosis in Manitoba
The rising prevalence and changing age distribution of multiple sclerosis in Manitoba
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DOI：
10.1212/wnl.0b013e3181cf6ec0
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发表时间：
2010-02-09
期刊：
影响因子：
9.9
通讯作者：
Elliott, L.
中科院分区：
文献类型：
--
作者：
Marrie, R. A.;Yu, N.;Elliott, L.
目的：几项研究表明，加拿大多发性硬化症（MS）的患病率正在上升。我们的目的是利用行政医疗保险数据验证多发性硬化症的病例定义，并描述多发性硬化症在加拿大马尼托巴省的发病率和患病率。方法：利用省级行政索赔数据，采用国际疾病分类9/10代码和处方索赔对脱髓鞘病患者进行识别。为了验证病例定义，向随机选择的2000名患有脱髓鞘疾病的人邮寄了调查问卷，要求允许对医疗记录进行审查。我们使用从医疗记录中提取的诊断作为金标准来评估使用管理数据的候选病例定义。结果：1984 - 1997年，使用索赔数据的MS病例被定义为有>= 7次MS医疗接触者。1998年以后，病例被定义为有>= 3次MS医疗接触者。与病案比较，该定义阳性预测值为80.5%，阴性预测值为75.5%。从1998年到2006年，每10万人中经年龄和性别调整的MS年平均发病率为11.4（95%可信区间[CI] 10.7-12.0）。年龄调整后的MS患病率从1984年的每10万人32.6例（95% CI 29.4-35.8）增加到2006年的226.7例（95% CI 218.1-235.3），患病率高峰转移到年龄较大的人群。结论：曼尼托巴省多发性硬化症（MS）患病率居世界前列。患病率上升，发病率变化不大，提示生存率提高。本研究支持使用行政数据来制定病例定义，并进一步定义ms神经病学的流行病学(R) 2010；74: 465 - 471
Objective: Several studies suggest an increasing prevalence of multiple sclerosis (MS) in Canada. We aimed to validate a case definition for MS using administrative health insurance data, and to describe the incidence and prevalence of MS in Manitoba, Canada.Methods: We used provincial administrative claims data to identify persons with demyelinating disease using International Classification of Diseases 9/10 codes and prescription claims. To validate the case definition, questionnaires were mailed to 2,000 randomly selected persons with an encounter for demyelinating disease, requesting permission for medical records review. We used diagnoses abstracted from medical records as the gold standard to evaluate candidate case definitions using administrative data.Results: From 1984 to 1997, cases of MS using claims data were defined as persons with >= 7 medical contacts for MS. From 1998 onward, cases were defined as persons with >= 3 medical contacts. As compared to medical records, this definition had a positive predictive value of 80.5% and negative predictive value of 75.5%. From 1998 to 2006, the average age-and sex-adjusted annual incidence of MS per 100,000 population was 11.4 (95% confidence interval [CI] 10.7-12.0). The age-adjusted prevalence of MS per 100,000 population increased from 32.6 (95% CI 29.4-35.8) in 1984 to 226.7 (95% CI 218.1-235.3) in 2006, with the peak prevalence shifting to older age groups.Conclusion: The prevalence of multiple sclerosis (MS) in Manitoba is among the highest in the world. The rising prevalence with minimally changing incidence suggests improving survival. This study supports the use of administrative data to develop case definitions and further define the epidemiology of MS. Neurology (R) 2010; 74: 465-471