Validation of Kidney Transplantation Using Administrative Data

Abstract

BackgroundAdministrative data are increasingly being used to assess outcomes in kidney transplant recipients.ObjectiveTo assess the validity of transplant data in healthcare administrative databases compared to the reference standard of information collected directly from transplant centres.DesignRetrospective cohort study.SettingOne of three major transplant centres in Ontario (Toronto General Hospital, University Hospital – London, and Ottawa Hospital).PatientsRecipients who received a kidney-only transplant between 2008 and 2011.MeasurementsFor each data source, we identified kidney transplants performed. We calculated the sensitivity and positive predictive value (PPV) of the administrative data for the reference standard data.MethodsThe data collected from transplant centres were compared with data from the Canadian Organ Replacement Register (CORR) database, a hospital procedural code from the Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD), and provincial physician billing claims from the Ontario Health Insurance Plan (OHIP) database.ResultsDuring the study period, the three centres reported a total of 1112 kidney transplants performed. The probability of identifying kidney transplant recipients in CORR, CIHI, and OHIP, given they were identified by the transplant centres (sensitivity), was 96%, 98%, and 98% respectively. The probability that the database code correctly identified a transplant recipient (positive predictive value) in CORR, CIHI, and OHIP was 98%, 98%, and 96% respectively.LimitationsWe validated the information from 2008 to 2011 and cannot attest to the reliability of the data beyond the study period. Specifically, we would not regard this as evidence that applies to the earlier years, shortly after the inception of the databases. Secondly, we were unable to distinguish between first and repeat transplantation.ConclusionsCodes in CORR, CIHI, and OHIP each operate well in the detection of kidney transplant recipients. These data sources can be used to efficiently identify and follow kidney transplant recipients for post-transplant outcomes.

The Risk of Cardiovascular Disease Is Not Increasing Over Time Despite Aging and Higher Comorbidity Burden of Kidney Transplant Recipients

“…Compared with information collected at the transplant centers, CORR accurately identified kidney transplant recipients with a sensitivity of 96% and a positive predictive value of 98%. 10 Demographic and vital status information was accessed from Ontario's Registered Persons Database. Diagnostic and procedural information during hospital admissions was gathered from the Canadian Institute for Health Information Discharge Abstract Database.…”

Venous Thromboembolism and the Risk of Death and Graft Loss in Kidney Transplant Recipients

“…Kidney transplant recipients were identified from the Canadian Organ Replacement Register (CORR) that captures all dialysis and kidney transplant activity in Canada. Compared to information collected at the transplant centers, CORR accurately identifies kidney transplant recipients with a sensitivity of 96% and a positive predictive value of 98% [12]. Demographic and vital status information was accessed from Ontario's Registered Persons Database.…”

Variation in Access to Kidney Transplantation Across Renal Programs in Ontario, Canada

“…Our primary outcome was receipt of a kidney transplant at 1, 5, and 10 years after dialysis initiation, as captured in CORR or ORRS (Table S1). CORR has been shown to accurately identify kidney transplant recipients compared with data from transplant centers, with sensitivity >95% .…”