Assessment of recording bias in pregnancy studies using health care databases: An application to neurologic conditions.
Assessment of recording bias in pregnancy studies using health care databases: An application to neurologic conditions.
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DOI：
10.1111/ppe.12459
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发表时间：
2018-05
影响因子：
2.8
通讯作者：
Hernández-Díaz S
中科院分区：
文献类型：
--
作者：
MacDonald SC;Hernán MA;McElrath TF;Hernández-Díaz S
医疗保健数据库中的既存疾病记录不完整。我们评估了在分娩记录中存在主要产科结局（剖腹产、早产、先兆子痫）的情况下，预先存在的神经系统疾病（癫痫、多发性硬化[MS]）是否被差异记录。我们还评估了差异记录对频率测量的影响以及条件和结果之间的关联。2011-2014年Truven Health MarketScan®商业索赔数据集用于确定交付情况。我们计算了分娩时癫痫和MS的相对记录，并与分娩前270天的间隔进行比较，包括总体和主要产科结局的存在。我们估计了癫痫和MS之间的关联的风险比与每个确定窗口的结果。我们确定了909，065例分娩，这些妇女从分娩日期前270天开始连续登记。在分娩前确定的癫痫妇女中，73%在分娩时有条件编码。对于MS，所述比例为60%。分娩时的MS记录并不因产科结局而异，然而，在存在先兆子痫的情况下，分娩编码的癫痫在分娩前间隔中不太可能得到证实。一般来说，确定的时间段对风险比没有意义的影响，但是，当分娩时确定癫痫时，与癫痫相关的先兆子痫的风险比为1.67 [95%CI：1.47，1.90]，当分娩前确定癫痫时，与癫痫相关的先兆子痫的风险比为1.26 [95%CI：1.07，1.48]（异质性，p=0.007）。分娩记录中癫痫和MS的确定低估了患病率。然而，记录的窗口一般不会影响与产科结局的关联。
Pre-existing conditions are imperfectly recorded in healthcare databases. We assessed whether pre-existing neurologic conditions (epilepsy, multiple sclerosis [MS]) were differentially recorded in the presence of major obstetric outcomes (Caesarean delivery, preterm delivery, preeclampsia) in delivery records. We also evaluated the impact of differential recording on measures of frequency and association between the conditions and outcomes. The 2011-2014 Truven Health MarketScan® Commercial Claims Dataset was used to identify deliveries. We calculated the relative recording of epilepsy and MS at delivery compared with a 270-day pre-delivery interval, both overall and by the presence of major obstetric outcomes. We estimated risk ratios of the association between epilepsy and MS with the outcomes for each ascertainment window. We identified 909,065 deliveries in women continuously enrolled from 270-days before the delivery date. Of women with epilepsy identified in the pre-delivery interval, 73% had the condition coded at delivery. For MS, the proportion was 60%. MS recording at delivery did not vary by obstetric outcomes, however delivery-coded epilepsy was less likely confirmed in the pre-delivery interval in the presence of preeclampsia. Generally, the period of ascertainment did not meaningfully impact risk ratios, however the risk ratio for preeclampsia associated with epilepsy was 1.67 [95% CI: 1.47, 1.90] when epilepsy was ascertained at delivery and 1.26 [95% CI: 1.07, 1.48] when epilepsy was ascertained in the pre-delivery interval (heterogeneity, p=0.007). Ascertainment of epilepsy and MS in delivery records underestimated prevalence. However the window of recording generally did not impact associations with obstetric outcomes.
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影响因子：
7.7
作者：
DREWS, CD;KRAUS, JF;GREENLAND, S
通讯作者：
GREENLAND, S
影响因子：
9.8
作者：
Richmond, JR;Krishnamoorthy, P;Benjamin, A
通讯作者：
Benjamin, A
影响因子：
3.7
作者：
Palmsten, Kristin;Huybrechts, Krista F.;Hernandez-Diaz, Sonia
通讯作者：
Hernandez-Diaz, Sonia
影响因子：
9.9
作者：
Marrie, R. A.;Yu, N.;Elliott, L.
通讯作者：
Elliott, L.
DOI：
10.1682/jrrd.2004.09.0122
发表时间：
2006-01-01
影响因子：
--
作者：
Culpepper, William J., II;Ehrmantrant, Mary;Bradham, Douglas D.
通讯作者：
Bradham, Douglas D.