Validating epilepsy diagnoses in routinely collected data
Validating epilepsy diagnoses in routinely collected data
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DOI：
10.1016/j.seizure.2017.10.008
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发表时间：
2017-11-01
影响因子：
3
通讯作者：
Pickrell, W. Owen
中科院分区：
文献类型：
--
作者：
Fonferko-Shadrach, Beata;Lacey, Arron S.;Pickrell, W. Owen
目的：匿名的、匿名收集的医疗数据越来越多地用于癫痫研究。我们使用全科医生（GP）的初级医疗保健记录验证了算法，以从英国威尔士安全匿名信息链接（SAIL）数据库中的匿名医疗保健数据中识别癫痫患者。方法：从医院记录中确定了150名明确癫痫患者和150名无癫痫患者的参考人群，并将其与SAIL中包含的记录相关联（包含240万人的GP记录）。我们使用了三种不同的算法，使用GP癫痫诊断和抗癫痫药物（AED）处方代码的组合来识别参考人群。结果：组合诊断和AED处方代码的灵敏度为84%（95%CI77-90），特异性98%（95-100）;单独诊断代码的敏感性为86%（80 - 91），特异性为97%（92 - 99）;单独AED处方代码的敏感性为92%（70 - 83），特异性为73%（65 - 80）。仅使用AED代码在儿童中更准确，敏感性为88%（75 - 95），特异性为98%（88 - 100）。结论：GP癫痫诊断和AED处方代码可以自信地用于识别使用匿名医疗记录的癫痫患者。(C)2017年，作者。由Elsevier Ltd代表英国癫痫协会出版。这是一个在CC BY许可证下的开放获取文章（http：//creativecommons.org/licenses/by/4.0/）。
Purpose: Anonymised, routinely-collected healthcare data is increasingly being used for epilepsy research. We validated algorithms using general practitioner (GP) primary healthcare records to identify people with epilepsy from anonymised healthcare data within the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK.Method: A reference population of 150 people with definite epilepsy and 150 people without epilepsy was ascertained from hospital records and linked to records contained within SAIL (containing GP records for 2.4 million people). We used three different algorithms, using combinations of GP epilepsy diagnosis and anti-epileptic drug (AED) prescription codes, to identify the reference population.Results: Combining diagnosis and AED prescription codes had a sensitivity of 84% (95% ci 77-90) and specificity of 98% (95-100) in identifying people with epilepsy; diagnosis codes alone had a sensitivity of 86% (80-91) and a specificity of 97% (92-99); and AED prescription codes alone achieved a sensitivity of 92% (70-83) and a specificity of 73% (65-80). Using AED codes only was more accurate in children achieving a sensitivity of 88% (75-95) and specificity of 98% (88-100).Conclusion: GP epilepsy diagnosis and AED prescription codes can be confidently used to identify people with epilepsy using anonymised healthcare records in Wales, UK. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of British Epilepsy Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).