The use of administrative health care databases to identify patients with rheumatoid arthritis

John G Hanly,1,2 Kara Thompson,3 Chris Skedgel4 1Division of Rheumatology, Department of Medicine, 2Department of Pathology, 3Department of Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 4Atlantic Clinical Cancer Research Unit, Capital Health, Halifax, Nova Scotia, Canada...

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Autores principales:	Hanly JG, Thompson K, Skedgel C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/a3e9dd15d9694637b66fa8ce5090b095
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spelling	oai:doaj.org-article:a3e9dd15d9694637b66fa8ce5090b0952021-12-02T04:59:07ZThe use of administrative health care databases to identify patients with rheumatoid arthritis1179-156Xhttps://doaj.org/article/a3e9dd15d9694637b66fa8ce5090b0952015-11-01T00:00:00Zhttps://www.dovepress.com/the-use-of-administrative-health-care-databases-to-identify-patients-w-peer-reviewed-article-OARRRhttps://doaj.org/toc/1179-156XJohn G Hanly,1,2 Kara Thompson,3 Chris Skedgel4 1Division of Rheumatology, Department of Medicine, 2Department of Pathology, 3Department of Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 4Atlantic Clinical Cancer Research Unit, Capital Health, Halifax, Nova Scotia, Canada Objective: To validate and compare the decision rules to identify rheumatoid arthritis (RA) in administrative databases. Methods: A study was performed using administrative health care data from a population of 1 million people who had access to universal health care. Information was available on hospital discharge abstracts and physician billings. RA cases in health administrative databases were matched 1:4 by age and sex to randomly selected controls without inflammatory arthritis. Seven case definitions were applied to identify RA cases in the health administrative data, and their performance was compared with the diagnosis by a rheumatologist. The validation study was conducted on a sample of individuals with administrative data who received a rheumatologist consultation at the Arthritis Center of Nova Scotia. Results: We identified 535 RA cases and 2,140 non-RA, noninflammatory arthritis controls. Using the rheumatologist's diagnosis as the gold standard, the overall accuracy of the case definitions for RA cases varied between 68.9% and 82.9% with a kappa statistic between 0.26 and 0.53. The sensitivity and specificity varied from 20.7% to 94.8% and 62.5% to 98.5%, respectively. In a reference population of 1 million, the estimated annual number of incident cases of RA was between 176 and 1,610 and the annual number of prevalent cases was between 1,384 and 5,722. Conclusion: The accuracy of case definitions for the identification of RA cases from rheumatology clinics using administrative health care databases is variable when compared to a rheumatologist's assessment. This should be considered when comparing results across studies. This variability may also be used as an advantage in different study designs, depending on the relative importance of sensitivity and specificity for identifying the population of interest to the research question. Keywords: inflammatory arthritis, case definitions, incidence, prevalence, population healthHanly JGThompson KSkedgel CDove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2015, Iss default, Pp 69-75 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Hanly JG Thompson K Skedgel C The use of administrative health care databases to identify patients with rheumatoid arthritis
description	John G Hanly,1,2 Kara Thompson,3 Chris Skedgel4 1Division of Rheumatology, Department of Medicine, 2Department of Pathology, 3Department of Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 4Atlantic Clinical Cancer Research Unit, Capital Health, Halifax, Nova Scotia, Canada Objective: To validate and compare the decision rules to identify rheumatoid arthritis (RA) in administrative databases. Methods: A study was performed using administrative health care data from a population of 1 million people who had access to universal health care. Information was available on hospital discharge abstracts and physician billings. RA cases in health administrative databases were matched 1:4 by age and sex to randomly selected controls without inflammatory arthritis. Seven case definitions were applied to identify RA cases in the health administrative data, and their performance was compared with the diagnosis by a rheumatologist. The validation study was conducted on a sample of individuals with administrative data who received a rheumatologist consultation at the Arthritis Center of Nova Scotia. Results: We identified 535 RA cases and 2,140 non-RA, noninflammatory arthritis controls. Using the rheumatologist's diagnosis as the gold standard, the overall accuracy of the case definitions for RA cases varied between 68.9% and 82.9% with a kappa statistic between 0.26 and 0.53. The sensitivity and specificity varied from 20.7% to 94.8% and 62.5% to 98.5%, respectively. In a reference population of 1 million, the estimated annual number of incident cases of RA was between 176 and 1,610 and the annual number of prevalent cases was between 1,384 and 5,722. Conclusion: The accuracy of case definitions for the identification of RA cases from rheumatology clinics using administrative health care databases is variable when compared to a rheumatologist's assessment. This should be considered when comparing results across studies. This variability may also be used as an advantage in different study designs, depending on the relative importance of sensitivity and specificity for identifying the population of interest to the research question. Keywords: inflammatory arthritis, case definitions, incidence, prevalence, population health
format	article
author	Hanly JG Thompson K Skedgel C
author_facet	Hanly JG Thompson K Skedgel C
author_sort	Hanly JG
title	The use of administrative health care databases to identify patients with rheumatoid arthritis
title_short	The use of administrative health care databases to identify patients with rheumatoid arthritis
title_full	The use of administrative health care databases to identify patients with rheumatoid arthritis
title_fullStr	The use of administrative health care databases to identify patients with rheumatoid arthritis
title_full_unstemmed	The use of administrative health care databases to identify patients with rheumatoid arthritis
title_sort	use of administrative health care databases to identify patients with rheumatoid arthritis
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/a3e9dd15d9694637b66fa8ce5090b095
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The use of administrative health care databases to identify patients with rheumatoid arthritis

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