Validation of a COPD diagnosis from the Swedish Inpatient Registry
Validation of a COPD diagnosis from the Swedish Inpatient Registry
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DOI：
10.1177/1403494812463172
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发表时间：
2012-12-01
影响因子：
3.4
通讯作者：
Egesten, Arne
中科院分区：
文献类型：
--
作者：
Inghammar, Malin;Engstrom, Gunnar;Egesten, Arne
目的：瑞典国家住院患者登记处是许多流行病学研究的重要数据来源，其中包括慢性阻塞性肺疾病（COPD）研究。一般验证研究表明，一般85-95%的诊断报告是正确的，但这是不正确的所有疾病组，为什么具体的验证研究是非常重要的。研究方法：2000年至2007年期间，从Skane县的两家中心医院和两家大学医院出院的374名COPD诊断患者的图表与原始医疗档案进行了验证。COPD诊断的确定性程度的标准是预先定义的，诊断概率和确定性水平的预测因子之间的关联使用有序逻辑回归模型进行评估。结果如下：根据慢性阻塞性肺疾病全球倡议标准，21.7%的诊断被归类为已证实的COPD，35.5%被归类为很可能，另外34.0%被归类为可能的COPD，2.1%被归类为不确定的诊断，7.0%被归类为不太可能的COPD诊断。年龄类别（调整后OR：60-79岁，2.6，95%CI 1.2-5.4; >= 80岁，1.6，95%CI 0.7-3.3）和从非手术部门出院（调整后OR：1.7，95%CI 1.1-2.8）与较高的诊断确定性水平显著相关。结论：来自瑞典住院患者登记处的COPD诊断对于流行病学研究是可接受的有效性。诊断的确定性程度各不相同，但低于10%被认为是错误分类或具有不确定的COPD诊断。
Aims: The Swedish National Inpatient Registry is an important source of data for numerous epidemiological studies, amongst them studies on chronic obstructive pulmonary disease (COPD). General validation studies indicate that in general 85-95% of diagnoses reported are correct, but this is not true for all groups of diseases, why specific validation studies are of great importance. Methods: Charts from 374 individuals discharged with a COPD diagnosis between 2000-07 from two central hospitals and two university hospitals in the county of Skane were validated against the original medical files. Criteria for the degree of certainty of the COPD diagnosis were predefined and the association between predictors of diagnostic probability and the level of certainty was assessed using an ordinal logistic regression model. Results: According to the Global Initiative for Chronic Obstructive Lung Disease criteria, 21.7% of the diagnosis were classified as proven COPD, 35.5% were classified as probable, another 34.0% as possible COPD, 2.1% were classified as having an uncertain diagnosis, and 7.0% as an unlikely COPD diagnosis. Age category (adjusted ORs: 60-79 years, 2.6, 95% CI 1.2-5.4; >= 80 years, 1.6, 95% CI 0.7-3.3) and discharge from a non-surgical department (adjusted OR: 1.7, 95% CI 1.1-2.8) were significantly associated with higher level of diagnostic certainty. Conclusions: A COPD diagnoses from the Swedish Inpatient Registry is of acceptable validity for epidemiological research. The degree of certainty of the diagnosis varies but less than 10% were considered as misclassified or having an uncertain COPD diagnosis.