Identification of asthmatic children using prescription data and diagnosis
Identification of asthmatic children using prescription data and diagnosis
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DOI：
10.1007/s00228-007-0286-4
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发表时间：
2007-06-01
影响因子：
2.9
通讯作者：
Schiotz, P. O.
中科院分区：
文献类型：
--
作者：
Moth, Grete;Vedsted, Peter;Schiotz, P. O.
目的本研究的目的是开发和验证一种方法，用于识别哮喘儿童6至14岁之间的处方数据的基础上，抗哮喘药物和诊断data.Methods登记为基础的研究，125,907丹麦儿童6-14岁，确定了9695名儿童赎回至少一个抗哮喘药物处方在2002年。这些儿童的哮喘诊断通过出院信息和全科医生填写的问卷进行验证。对基于不同类型药物组合的模型进行了测试，以找到最佳模型，该模型将包括尽可能多的具有有效诊断的儿童，并排除尽可能多的假阳性。结果：应用该方法检测儿童的特异性最高为0.86 [95%CI：0.84-0.87]，敏感性为0.63（95%可信区间：0.62-0.65），其中包括儿童谁赎回处方的任何抗哮喘药物-除了处方的β 2-激动剂作为液体，在12个月期间，仅使用一种吸入性β 2受体激动剂或吸入性类固醇。观察时间延长6个月，特异性无显著提高（0.87; 95%CI：0.85-0.88），但敏感性显著降低（0.59; 95%CI：0.58-0.60）。这种方法将是有益的卫生服务研究和哮喘儿童的积极护理。
Objective The aim of the study was to develop and validate a method for identifying asthmatic children between 6 and 14 years of age based on prescription data on anti-asthmatic drugs and diagnostic data.Methods A register-based study of 125,907 Danish children aged 6-14 years identified 9695 children who had redeemed at least one anti-asthmatic drug prescription in 2002. The asthma diagnosis in these children was validated by discharge information and by a questionnaire completed by general practitioners. Models based on combinations of different types of drugs were tested to find the best model that would include as many children as possible with a validated diagnosis and exclude as many false positives as possible. Different time windows were tested in terms of detecting the children and the observation period of refilling prescriptions.Results The highest specificity of 0.86 [95% confidence interval (95% CI): 0.84-0.87] together with a sensitivity of 0.63 (95% CI: 0.62-0.65) were found in the model that included children who had redeemed a prescription for any anti-asthmatic drug - with the exception of prescriptions for beta2-agonists as liquid, one prescription only of inhaled beta2-agonist or an inhaled steroid - during a 12-month period. Lengthening the observation time by 6 months did not significantly improve the specificity (0.87; 95% CI: 0.85-0.88), but it did result in a statistically significantly lower sensitivity (0.59; 95% CI: 0.58-0.60).Conclusion Register-based data on redeemed prescriptions can be utilised to identify asthmatic school children. This method will be useful in health services research and in the proactive care of asthmatic children.