The Accuracy of Administrative Data Diagnoses of Systemic Autoimmune Rheumatic Diseases
The Accuracy of Administrative Data Diagnoses of Systemic Autoimmune Rheumatic Diseases
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DOI：
10.3899/jrheum.101149
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发表时间：
2011-08-01
影响因子：
3.9
通讯作者：
Hanly, John G.
中科院分区：
文献类型：
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作者：
Bernatsky, Sasha;Linehan, Tina;Hanly, John G.
Objective.通过与风湿病学记录的比较，检验基于管理数据的全身性自身免疫性风湿病[SARD;系统性红斑狼疮（SLE）、系统性硬化症（SSc）、肌炎、干燥综合征、血管炎和风湿性多肌痛]病例定义的有效性。风湿性疾病诊断列表由基于人群的行政账单和住院数据库生成。研究对象由关节炎中心的风湿病学家诊断，并回顾其医疗记录。我们发现，844名新斯科舍省居民根据行政管理数据诊断为感兴趣的风湿性疾病之一，并在省级关节炎中心进行了>= 1次风湿病学评估。824名受试者的图表可用，其中一些人在行政数据库中被确定为具有> 1个诊断。因此，共有1136项诊断可用于对照临床记录进行验证。在824例受试者中，680例（83%）的管理数据库诊断在病历审查中得到确认。在管理数据中，大多数给定风湿性疾病的“假阳性”受试者具有类似风湿性疾病的真实诊断。基于特定管理数据的病例定义的大多数敏感性估计值> 90%，尽管对于SSc，敏感性为80.5%。除SLE的特异性为72. 5%外，其他指标的特异性均> 90%。虽然卫生行政数据可能是一种有效的资源，但在病例定义的特异性和敏感性方面存在潜在的问题，在未来的研究中应牢记这一点。（2011年5月1日首次发布; J Rheumol 2011;38：1612-16; doi：10.3899/jrheum.101149）
Objective. To examine the validity of case definitions for systemic autoimmune rheumatic diseases [SARD; systemic lupus erythematosus (SLE), systemic sclerosis (SSc), myositis, Sjogren's syndrome, vasculitis, and polymyalgia rheumatica] based on administrative data, compared to rheumatology records.Methods. A list of rheumatic disease diagnoses was generated from population-based administrative billing and hospitalization databases. Subjects who had been seen by an arthritis center rheumatologist were identified, and the medical records reviewed.Results. We found that 844 Nova Scotia residents had a diagnosis of one of the rheumatic diseases of interest, based on administrative data, and had had >= 1 rheumatology assessment at a provincial arthritis center. Charts were available on 824 subjects, some of whom had been identified in the administrative database with > 1 diagnosis. Thus a total of 1136 diagnoses were available for verification against clinical records. Of the 824 subjects, 680(83%) had their administrative database diagnoses confirmed on chart review. The majority of subjects who were "false-positive" for a given rheumatic disease on administrative data had a true diagnosis of a similar rheumatic disease. Most sensitivity estimates for specific administrative data-based case definitions were > 90%, although for SSc, the sensitivity was 80.5%. The specificity estimates were also > 90%, except for SLE, where the specificity was 72.5%.Conclusion. Although health administrative data may be a valid resource, there are potential problems regarding the specificity and sensitivity of case definitions, which should be kept in mind for future studies. (First Release May 1 2011; J Rheumatol 2011;38:1612-16; doi:10.3899/jrheum.101149)