Is the Quebec provincial administrative database a valid source for research on chronic non-cancer pain?
Is the Quebec provincial administrative database a valid source for research on chronic non-cancer pain?
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DOI：
10.1002/pds.3820
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发表时间：
2015-09-01
影响因子：
2.6
通讯作者：
Choiniere, Manon
中科院分区：
文献类型：
--
作者：
Lacasse, Anais;Ware, Mark A.;Choiniere, Manon
本研究的目的是评估记录在魁北克省L疾病登记处行政数据库中的诊断代码在识别不同类型慢性非癌性疼痛患者方面的有效性。方法以魁北克省疼痛登记处登记的5 61例疼痛专科医生建立的诊断数据为参考标准，检验出版的《国际疾病分类》第九版编码算法对魁北克省疼痛登记处登记的5 61例慢性疼痛综合征患者进行识别的有效性。这些算法的修改版本(即，适应医疗保健遭遇的次数)也进行了测试。结果在RAMQ数据库中，以前发表的一些算法和这些算法的修改版本被发现对慢性腰痛(敏感性：0.65，95%CI：0.59-0.71；特异性：0.83，95%CI：0.79-0.87)、慢性腰痛(敏感性：0.70，95%CI：0.64-0.76；特异性：0.73，95%CI：0.68~0.78；慢性颈背痛(敏感性：0.71，95%CI：0.65~0.76；特异性：0.78，95%CI：0.72~0.82)。识别其他类型慢性疼痛患者的算法显示出较低的敏感性：复杂区域疼痛综合征(0.07)、纤维肌痛(0.42)和神经病理性疼痛(0.39)。结论我们的研究为RAMQ管理数据库的价值提供了证据，用于开展包括背部和颈部疼痛在内的特定类型的慢性疼痛疾病的研究。然而，对于研究其他类型的慢性疼痛综合征，如复杂的区域疼痛综合征、纤维肌痛和神经病理性疼痛，使用者应谨慎对待该数据库的局限性。版权所有(C)2015 John Wiley&Sons，Ltd.
PurposeThe objective of this study was to evaluate the validity of diagnostic codes recorded in the Regie de l'assurance maladie du Quebec (RAMQ) administrative database for identifying patients suffering from various types of chronic non-cancer pain.MethodsThe validity of published International Classification of Diseases, Ninth Revision, coding algorithms for identifying patients with particular chronic pain syndromes in the RAMQ database was tested using pain specialist-established diagnostic data of 561 patients enrolled in the Quebec Pain Registry, which was used as the reference standard. Modified versions of these algorithms (i.e., adaptation of the number of healthcare encounters) were also tested. For each algorithm, sensitivity, specificity, positive/negative predictive values, and their respective 95% confidence intervals (95%CI) were calculated.ResultsIn the RAMQ database, some previously published algorithms and modified versions of these algorithms were found to be valid for identifying patients suffering from chronic lumbar pain (sensitivity: 0.65, 95%CI: 0.59-0.71; specificity: 0.83, 95%CI: 0.79-0.87), chronic back pain (sensitivity: 0.70, 95%CI: 0.64-0.76; specificity: 0.73, 95%CI: 0.68-0.78), and chronic neck/back pain (sensitivity: 0.71, 95%CI: 0.65-0.76; specificity: 0.78, 95%CI: 0.72-0.82). Algorithms to identify patients with other types of chronic pain showed low sensitivity: complex regional pain syndrome (0.07), fibromyalgia (0.42), and neuropathic pain (0.39).ConclusionsOur study provides evidence supporting the value of the RAMQ administrative database for conducting research on certain types of chronic pain disorders including back and neck pain. Users should, however, be cautious about the limitations of this database for studying other types of chronic pain syndromes such as complex regional pain syndrome, fibromyalgia, and neuropathic pain. Copyright (c) 2015 John Wiley & Sons, Ltd.