Identifying patients with physician-diagnosed asthma in health administrative databases
Identifying patients with physician-diagnosed asthma in health administrative databases
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DOI：
10.1155/2009/963098
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发表时间：
2009-11-01
影响因子：
2.2
通讯作者：
To, Teresa
中科院分区：
文献类型：
--
作者：
Gershon, Andrea S.;Wang, Chengning;To, Teresa
背景：哮喘给个人和人群带来了沉重而昂贵的负担。基于卫生行政数据的人群监测和研究项目可以测量和研究哮喘的负担;然而，必须首先确认哮喘的卫生行政数据诊断的有效性。目的：评估基于人群的省级卫生行政数据在识别成人哮喘患者以进行持续监测和研究方面的准确性。从随机选择的初级保健实践中的患者根据他们以前的诊断被分配到四个类别：哮喘，慢性阻塞性肺疾病，相关的呼吸系统疾病和非哮喘疾病。在每次实践中，从每个类别中随机选择10张图表，提取，然后由盲法专家小组进行审查，确定它们是哮喘还是非哮喘。然后将这些参考标准诊断与患者的省级记录联系起来，并与旨在识别哮喘的健康管理算法进行比较。使用诊断测试evaluation.Results的概念进行分析：共518图表，包括160个哮喘患者，进行了审查。两个或两个以上的门诊治疗访问和/或一个或多个哮喘住院（S）在两年内的算法的敏感性为83.8%（95%CI 77.1%至89.1%）和特异性为76.5%（95%CI 71.8%至80.8%）。结论：成人哮喘的定义使用卫生行政数据是敏感和特异性识别成人哮喘。使用这些定义，可以开发正在进行的基于人群的监测和研究的成人哮喘队列。
BACKGROUND: Asthma imposes a heavy and expensive burden on individuals and populations. A population-based surveillance and research program based on health administrative data Could measure and Study the burden of asthma; however, the validity of a health administrative data diagnosis of asthma must first be confirmed.OBJECTIVE: To evaluate the accuracy of population-based provincial health administrative data in identifying adult patients with asthma for ongoing surveillance and research.METHODS: Patients from randomly selected primary care practices were assigned to four categories according to their previous diagnoses: asthma, chronic obstructive Pulmonary disease, related respiratory conditions and nonasthma conditions. In each practice, 10 charts from each category were randomly selected, abstracted, then reviewed by a blinded expert panel who identified them as asthma or nonasthma. These reference standard diagnoses were then linked to the patients' provincial records and compared with health administrative algorithms designed to identify asthma. Analyses were performed using the concepts of diagnostic test evaluation.RESULTS: A total of 518 charts, including 160 from individuals with asthma, were reviewed. The algorithm of two or more ambulatory care visits and/or one or more hospitalization(s) for asthma in two years had a sensitivity of 83.8% (95% Cl 77.1% to 89.1%) and a specificity of 76.5% (95% Cl 71.8% to 80.8%).CONCLUSION: Definitions of adult asthma Using health administrative data are sensitive and specific for identifying adults with asthma. Using these definitions, cohorts of adults with asthma for ongoing Population-based Surveillance and research can be developed.