Comparison of the validity of stroke diagnoses in a medical quality register and an administrative health register

Varmdal, Torunn; Bakken, Inger Johanne; Janszky, Imre; Wethal, Torgeir; Ellekjær, Hanne; Rohweder, Gitta; Fjærtoft, Hild; Ebbing, Marta; Bønaa, Kaare Harald

doi:10.1177/1403494815621641

Cited by 61 publications

(77 citation statements)

References 18 publications

(14 reference statements)

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“…A recent Norwegian study reported a PPV of 79.7% for hospital admissions with a main or secondary diagnosis of acute stroke (ICD-10: I61, I63, and I64) when compared with adjudication of medical records; 65% of the false-positives were defined as previous strokes, rehabilitations after stroke or old strokes not previously diagnosed 25. In the past, however, patients with ischaemic stroke were not consistently admitted to hospitals for exact diagnosis and specific treatment, although this practice has become more standard in the past decade 26.…”

Section: Discussionmentioning

confidence: 99%

Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project

et al. 2016

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ObjectiveUpdated knowledge on the validity of self-reported myocardial infarction (SMI) and self-reported stroke (SRS) is needed in Norway. Our objective was to compare questionnaire data and hospital discharge data from regions with Sami and Norwegian populations to assess the validity of these outcomes by ethnicity, sex, age and education.DesignValidation study using cross-sectional questionnaire data and hospital discharge data from all Norwegian somatic hospitals.Participants and setting16 865 men and women aged 30 and 36–79 years participated in the Population-based Study on Health and Living Conditions in Sami and Norwegian Populations (SAMINOR) 1 Survey in 2003–2004. Information on SMI and SRS was available from self-administered questionnaires for 15 005 and 15 088 of these participants, respectively. We compared this information with hospital discharge data from 1994 until SAMINOR 1 Survey attendance.Primary and secondary outcomesSensitivity, specificity, positive predictive value (PPV), negative predictive value and κ.ResultsThe sensitivity and PPV of SMI were 90.1% and 78.9%, respectively; the PPV increased to 93.1% when all ischaemic heart disease (IHD) diagnoses were included. The SMI prevalence estimate was 2.3% and hospital-based 2.0%. The sensitivity and PPV of SRS were 81.1% and 64.3%, respectively. The SRS prevalence estimate was 1.5% and hospitalisation-based 1.2%. Moderate to no variation was observed in validity according to ethnicity, sex, age and education.ConclusionsThe sensitivity and PPV of SMI were high and moderate, respectively; for SRS, both of these measures were moderate. Our results show that SMI from the SAMINOR 1 Survey may be used in aetiological/analytical studies in this population due to a high IHD-specific PPV. The SAMINOR 1 questionnaire may also be used to estimate the prevalence of acute myocardial infarction and acute stroke.

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Section: Discussionmentioning

confidence: 99%

Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project

et al. 2016

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“…Concordance is high for illnesses such as cancer and stroke (Bakken et al, 2012;Varmdal et al, 2016), with excellent specificity due to few false positives, but has only moderate sensitivity as an indicator of psychiatric illnesses, such as anxiety and major depression (Torvik et al, 2018). Concordance is high for illnesses such as cancer and stroke (Bakken et al, 2012;Varmdal et al, 2016), with excellent specificity due to few false positives, but has only moderate sensitivity as an indicator of psychiatric illnesses, such as anxiety and major depression (Torvik et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…The registry contains specialist-determined diagnoses, yet the diagnostic validity of the register for the purpose of epidemiological research for EDs has not been specifically tested or cross-checked with direct clinical examinations or other registries. Concordance is high for illnesses such as cancer and stroke (Bakken et al, 2012;Varmdal et al, 2016), with excellent specificity due to few false positives, but has only moderate sensitivity as an indicator of psychiatric illnesses, such as anxiety and major depression (Torvik et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Time trends in healthcare‐detected incidence of anorexia nervosa and bulimia nervosa in the Norwegian National Patient Register (2010–2016)

Reas

Rø

2018

Intl J Eating Disorders

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Objective: Few studies have investigated temporal trends in the incidence of eating disorders (EDs). This study investigated time trends in the age-and sex-specific incidence of healthcaredetected anorexia nervosa (AN) and bulimia nervosa (BN) from 2010 to 2016. Methods: Data were retrieved from the Norwegian National Patient Register as defined by the International Classification of Diseases (ICD-10): narrowly defined AN (F50.0), broadly defined AN (F50.0 + 50.1), narrowly defined BN (F50.2), and broadly defined BN (F50.2 + 50.3). The average annual percent changes (AAPCs) in incidence rates (IRs) were examined by Joinpoint regression analyses.Results: The overall (i.e., both genders, ages 10-49) rates of AN were stable across the 7-year period, with IRs ranging from 18.8 to 20.4 per 100,000 for narrowly defined AN and 33.2 to 39.5 per 100,000 for broadly defined AN, whereas overall rates of BN declined. Age-and gender-stratification revealed a significant average annual increase in AN (narrow and broad) among 10-to 14-year-old girls. The incidence of broadly defined AN also increased significantly among females aged 15-19 years between 2010 and 2012, before leveling off. Nearly universal declines in the incidence of narrowly and broadly defined BN among females occurred. IRs among males were stable and comparatively low, with no significant trends toward increasing or decreasing rates of AN or BN over time.Discussion: Although register-based studies provide an underestimate of the true incidence and may not accurately reflect population-level changes in true ED occurrence, this study extends our knowledge regarding trends in the detected incidence of EDs into the second decade of the 21st century. K E Y W O R D Sanorexia nervosa, bulimia nervosa, epidemiology, incidence, Joinpoint, time-trends The question of whether the incidence, or annual diagnostic rate, of anorexia nervosa (AN) and bulimia nervosa (BN) has increased over the past decades is a subject of debate. Long-term epidemiological data are valuable, yet challenging to obtain and interpret, and disposed to known methodological challenges (see Hart,

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“…All discharge diagnoses are exclusively assigned by the physicians treating the patient, and cannot later be altered. The registry receives data monthly and is used for reimbursement purposes, hospital activity statistics, and research (Varmdal et al, ). Coding of ICH discharge diagnoses in the NPR is of high quality, with positive predictive values for ICH hospital admissions exceeding 95% (Oie et al, ).…”

Section: Methodsmentioning

confidence: 99%

Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population‐based study

et al. 2018

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BackgroundAccurate and reliable clinical and radiological predictors of intracerebral hemorrhage (ICH) outcomes are needed to optimize treatment of ICH. The aim of this study was to investigate functional outcome and identify predictors of severe disability or death following ICH.Materials and methodsRetrospective population‐based study of spontaneous ICH. Clinical and radiological data were obtained from electronic medical records, and functional outcome estimated using the modified Rankin Scale (mRS) before ICH and at 3 and 12 months after ICH.ResultsFour hundred and fifty‐two patients were included (mean age 74.8 years, 45.6% females). Proportion of fatal outcome at 1 week was 22.1%, at 3 months 39.2%, and at 12 months 44.9%. Median mRS score before the ICH was 1 (interquartile range [IQR] 2); for survivors at 3 months, it was 5 (IQR 3); and at 12 months, it was 3 (IQR 2). Independent predictors of severe disability (mRS of 5) or death (mRS of 6) were use of oral antithrombotic drugs (OR 2.2, 95% CI 1.3–3.8, p = 0.04), mRS score before the ICH (OR 1.8, 95% CI 1.4–2.2, p < 0.001), Glasgow Coma Scale (GCS) on admission (OR 8.3, 95% CI 3.5–19.7, p < 0.001), hematoma volume >60 ml (OR 4.5, 05% CI 2.0–10.2, p < 0.001), and intraventricular hematoma extension (OR 1.8, 95% CI 0.8–4.2, p < 0.001).ConclusionIntracerebral hemorrhage is associated with high mortality, and more than one third of survivors end up with severe disability or death 3 months later. Predictors of severe disability or death were use of oral antithrombotic drugs, functional disability prior to ICH, low GCS on admission, larger hematoma volume, and intraventricular hematoma extension.

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Comparison of the validity of stroke diagnoses in a medical quality register and an administrative health register

Abstract: The Norwegian Stroke Register and the Norwegian Patient Register are adequately complete and correct to serve as valuable sources of data for epidemiological, clinical and healthcare studies, as well as for administrative purposes.

Cited by 61 publications

References 18 publications

Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project

Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project

Time trends in healthcare‐detected incidence of anorexia nervosa and bulimia nervosa in the Norwegian National Patient Register (2010–2016)

Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population‐based study

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