The prevalence of MS in the United States A population-based estimate using health claims data
The prevalence of MS in the United States A population-based estimate using health claims data
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DOI：
10.1212/wnl.0000000000007035
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发表时间：
2019-03-05
期刊：
影响因子：
9.9
通讯作者：
LaRocca, Nicholas G.
中科院分区：
文献类型：
--
作者：
Wallin, Mitchell T.;Culpepper, William J.;LaRocca, Nicholas G.
目的通过对多个行政健康索赔（AHC）数据集应用经验证的算法，生成美国全国多发性硬化（MS）患病率估计值。方法将经过验证的算法应用于私人，军事和公共AHC数据集，以识别2008年至2010年期间的MS成人病例。在每个数据集中，我们确定了3年的累积患病率，并按年龄、性别和人口普查地区分层。我们将特定保险和特定阶层的估计值应用于2010年美国人口普查数据，并汇总结果以计算2010年美国MS的患病率累积超过3年。我们还使用2个模型估计了2010年10年累积的患病率，并将我们的估计外推到2017年。结果2010年美国成年人群中MS的估计患病率累积超过10年为309.2/100，000（95%置信区间[CI] 308.1-310.1），代表727，344例病例。在同一时间段内，女性MS患病率为450.1/100，000（95% CI 448.1-451.6），男性为159.7（95% CI 158.7-160.6）（女性：男性比率2.8）。2010年MS的估计患病率在55至64岁年龄组中最高。确定了美国南北下降的患病率梯度。还列出了2017年MS患病率估计值。结论2010年美国MS患病率估计值是迄今为止报道的最高值，并提供证据表明南北梯度持续存在。我们严格的基于算法的方法来估计患病率是有效的，并有可能用于其他慢性神经系统疾病。
Objective To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets. Methods A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017. Results The estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1-310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1-451.6) for women and 159.7 (95% CI 158.7-160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017. Conclusion The estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.