Validity of Chronic Obstructive Pulmonary Disease Diagnoses in a Large Administrative Database

Lacasse, Yves; Daigle, Jean-Marc; Martin, S. Clark; Maltais, François

doi:10.1155/2012/260374

Cited by 42 publications

(50 citation statements)

References 32 publications

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“…13 A diagnostic algorithm for COPD used in a UK Clinical Practice Research Datalink study was less sensitive and specific, 14 and algorithms derived from administrative data had lower sensitivity and PPV than those observed in our study. [15][16][17] Little is known about diagnostic algorithms for osteoarthritis, though validation results from a predictive algorithm used in a computerized, diagnostic database in the United States had outcomes similar to those of this study. 18 The CPCSSN case definition for dementia performed better than those constructed from Quebec billing data (sensitivity of 12.9%-39.7%) 19 and Canadian administrative hospital discharge data (sensitivity of 32.3%-66.9%, specificity of 100.0%).…”

Section: Overall Study Samplesupporting

confidence: 61%

Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records

Williamson

Green

Birtwhistle

et al. 2014

The Annals of Family Medicine

193

225

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PURPOSEThe Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is Canada's first national chronic disease surveillance system based on electronic health record (EHR) data. The purpose of this study was to develop and validate case definitions and case-finding algorithms used to identify 8 common chronic conditions in primary care: chronic obstructive pulmonary disease (COPD), dementia, depression, diabetes, hypertension, osteoarthritis, parkinsonism, and epilepsy. METHODSUsing a cross-sectional data validation study design, regional and local CPCSSN networks from British Columbia, Alberta (2), Ontario, Nova Scotia, and Newfoundland participated in validating EHR case-finding algorithms. A random sample of EHR charts were reviewed, oversampling for patients older than 60 years and for those with epilepsy or parkinsonism. Charts were reviewed by trained research assistants and residents who were blinded to the algorithmic diagnosis. Sensitivity, specificity, and positive and negative predictive values (PPVs, NPVs) were calculated. RESULTSWe obtained data from 1,920 charts from 4 different EHR systems (Wolf, Med Access, Nightingale, and PS Suite). For the total sample, sensitivity ranged from 78% (osteoarthritis) to more than 95% (diabetes, epilepsy, and parkinsonism); specificity was greater than 94% for all diseases; PPV ranged from 72% (dementia) to 93% (hypertension); NPV ranged from 86% (hypertension) to greater than 99% (diabetes, dementia, epilepsy, and parkinsonism). CONCLUSIONSThe CPCSSN diagnostic algorithms showed excellent sensitivity and specificity for hypertension, diabetes, epilepsy, and parkinsonism and acceptable values for the other conditions. CPCSSN data are appropriate for use in public health surveillance, primary care, and health services research, as well as to inform policy for these diseases.

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Section: Overall Study Samplesupporting

confidence: 61%

Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records

Williamson

Green

Birtwhistle

et al. 2014

The Annals of Family Medicine

193

225

View full text Add to dashboard Cite

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“…Limited studies of hospitalizations in other settings have shown sensitivities of 55% to 65%, specificities of 67% to 90%, and a positive predictive value of 50.4%. 32,33 In addition, a study of ED records showed positive predictive values ranging from 60% to 100% depending on the ICD-9 code. 34 …”

Section: Discussionmentioning

confidence: 99%

Hospital Discharges, Readmissions, and ED Visits for COPD or Bronchiectasis Among US Adults

Ford

2015

Chest

117

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BACKGROUND Numbers and rates of hospitalizations and ED visits by patients with COPD are important metrics for surveillance purposes. The objective of this study was to examine trends in these rates from 2001 to 2012 among adults aged ≥ 18 years in the United States. METHODS Data from the Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) were examined for temporal trends in the numbers and rates of hospitalizations by patients with COPD or bronchiectasis, mean length of stay, in-hospital case-fatality rate, 30-day readmission rate, and numbers and rates of ED visits. RESULTS The national number of discharges with COPD or bronchiectasis as the principal diagnosis was about 88,000 higher in 2012 than in 2001, but the age-adjusted rate of discharges did not change significantly (range, 242.7-286.0 per 100,000 population, P trend = .554). In contrast, hospitalization rates for common cardiovascular disorders, pneumonia, and lung cancer decreased significantly by 27% to 68%, whereas the mean charge doubled and mean cost increased by 40%. From 2006 to 2011, the numbers of ED visits increased from 1,480,363 to 1,787,612. The age-adjusted rate increased nonsignificantly from 654 to 725 per 100,000 population (P trend = .072). CONCLUSIONS Despite many local and national efforts to reduce the burden of COPD, total hospitalizations and ED visits over the past decade have increased for COPD, and the age-adjusted rates of hospitalizations and ED visits for COPD or bronchiectasis have not changed significantly in the United States.

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“…Prevalence rates based on administrative data may be biased in the opposite direction. Lacasse and colleagues 24 conducted a large validation of COPD Note: COPD = chronic obstructive pulmonary disease. *Age-standardized prevalence for patients aged ≥ 18 yr = 3.4%; patients aged ≥ 40 yr = 5.3%, and patients aged ≥ 50 yr = 6.9%.…”

Section: Discussionmentioning

confidence: 99%

Chronic obstructive pulmonary disease in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network

et al. 2015

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CMAJ OPEN, 3(1) E15Research CMAJ OPEN C hronic obstructive pulmonary disease (COPD) is a substantial source of morbidity and mortality in Canada and globally. Estimates place the worldwide prevalence at 9%-10% from physiologic-based studies and 3%-8% from studies based on physician-or patient-reported diagnosis or symptoms.1,2 Globally, COPD is rated as the fifth leading cause of death, and ninth in contributions to loss of disability-adjusted life years.3,4 A recent systematic review of COPD epidemiology worldwide identified 12 Canadian studies, which produced prevalence estimates that ranged from 3% to 12%, depending on the method used.5 Canadian data from a study using spirometry to screen a populationbased sample suggest a rate of about 10%. 6 There are limited data on COPD either alone or in combination with other chronic diseases from primary care settings.In other countries, the limited reports on COPD prevalence in primary care settings show marked variation depending on the method of identification of illness. A study from the United Kingdom based on electronic records in the Computerized Patient Records Database found the prevalence of physician-diagnosed COPD to be less than 1% for women and only 1.35% for men.7 Another practice-based research network study from the UK that invited participants in a postal survey to come for spirometry if they had either symptoms or a smoking history found a much higher prevalence (4.1% overall, 9.6% in patients over 40 yr).8 A recent Spanish study using data from electronic medical records (EMRs) found a physician-diagnosed prevalence of 3.2%, 90% of whom were also found to have at least 1 comorbid condition. Background: Chronic obstructive pulmonary disease (COPD) is mostly managed within primary care, but there is little Canadian evidence from this setting. This study was undertaken to determine the prevalence of physician-diagnosed COPD in primary care practices, and the degree of comorbidity with other chronic conditions, and to assess patterns of medication prescribing.

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Validity of Chronic Obstructive Pulmonary Disease Diagnoses in a Large Administrative Database

Abstract: The results support the routine ascertainment of the validity of diagnoses before using administrative databases in clinical and health services research.

Cited by 42 publications

References 32 publications

Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records

Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records

Hospital Discharges, Readmissions, and ED Visits for COPD or Bronchiectasis Among US Adults

Chronic obstructive pulmonary disease in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network

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