Surveillance of systemic autoimmune rheumatic diseases using administrative data
Surveillance of systemic autoimmune rheumatic diseases using administrative data
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DOI：
10.1007/s00296-010-1591-2
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发表时间：
2011-04-01
影响因子：
4
通讯作者：
Joseph, L.
中科院分区：
文献类型：
--
作者：
Bernatsky, S.;Lix, L.;Joseph, L.
人们越来越有兴趣开发工具和方法来监测慢性风湿性疾病，利用现有的资源，如行政卫生数据库。为了说明这可能是如何工作的，我们使用基于人口的管理数据来估计和比较加拿大三个省的系统性自身免疫性风湿病（SARD）的患病率，评估区域差异和人口因素的影响。根据省级医生账单和住院数据确定SARD病例（系统性红斑狼疮、硬皮病、原发性干燥综合征、多发性肌炎/皮肌炎）。我们结合了来自三个案例定义的信息，使用分层贝叶斯潜在类回归模型来解释每个案例定义的不完美性质。使用考虑到计费和住院数据库不完善性质的方法，我们估计SARD的总体患病率约为每1，000名居民2-3例。分层流行率估计数表明，各省的人口趋势相似（即，女性的流行率高于男性，以及老年人的流行率更高）。老年女性的患病率接近或超过1/100，这可能反映了该组中原发性干燥综合征的高负担。根据人口统计调整后，城市比农村的流行率更高。在我们的工作中，患病率估计具有良好的表面有效性，并提供了有关潜在的区域和人口统计学差异的有用信息。我们的研究结果表明，监测某些风湿性疾病的管理数据可能确实是可行的。我们的工作强调了使用多个数据源的有用性，并对每个数据源中的错误进行了调整。
There is growing interest in developing tools and methods for the surveillance of chronic rheumatic diseases, using existing resources such as administrative health databases. To illustrate how this might work, we used population-based administrative data to estimate and compare the prevalence of systemic autoimmune rheumatic diseases (SARDs) across three Canadian provinces, assessing for regional differences and the effects of demographic factors. Cases of SARDs (systemic lupus erythematosus, scleroderma, primary Sjogren's, polymyositis/dermatomyositis) were ascertained from provincial physician billing and hospitalization data. We combined information from three case definitions, using hierarchical Bayesian latent class regression models that account for the imperfect nature of each case definition. Using methods that account for the imperfect nature of both billing and hospitalization databases, we estimated the over-all prevalence of SARDs to be approximately 2-3 cases per 1,000 residents. Stratified prevalence estimates suggested similar demographic trends across provinces (i.e. greater prevalence in females-versus-males, and in persons of older age). The prevalence in older females approached or exceeded 1 in 100, which may reflect the high burden of primary Sjogren's syndrome in this group. Adjusting for demographics, there was a greater prevalence in urban-versus-rural settings. In our work, prevalence estimates had good face validity and provided useful information about potential regional and demographic variations. Our results suggest that surveillance of some rheumatic diseases using administrative data may indeed be feasible. Our work highlights the usefulness of using multiple data sources, adjusting for the error in each.