A novel method to monitor rheumatoid arthritis prevalence using hospital and medication databases

IF 4.9 2区医学 Q1 Medicine

Arthritis Research & Therapy Pub Date : 2024-07-16 DOI:10.1186/s13075-024-03366-x

Louise Koller-Smith, Ahmed Mehdi, Lyn March, Leigh Tooth, Gita D. Mishra, Ranjeny Thomas

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引用次数: 0

Abstract

Most estimates of rheumatoid arthritis (RA) prevalence, including all official figures in Australia and many other countries, are based on self-report. Self-report has been shown to overestimate RA, but the ‘gold standard’ of reviewing individual medical records is costly, time-consuming and impractical for large-scale research and population monitoring. This study provides an algorithm to estimate RA cases using administrative data that can be adjusted for use in multiple contexts to provide the first approximate RA cohort in Australia that does not rely on self-report. Survey data on self-reported RA and medications from 25 467 respondents of the Australian Longitudinal Study on Women’s Health (ALSWH) were linked with data from the national medication reimbursement database, hospital and emergency department (ED) episodes, and Medicare Benefits codes. RA prevalence was calculated for self-reported RA, self-reported RA medications, dispensed RA medications, and hospital/ED RA presentations. Linked data were used to exclude individuals with confounding autoimmune conditions. Of 25 467 survey respondents, 1367 (5·4%) women self-reported disease. Of the 26 840 women with hospital or ED presentations, 292 (1·1%) received ICD-10 codes for RA. There were 1038 (2·8%) cases by the medication database definition, and 294 cases (1·5%) by the self-reported medication definition. After excluding individuals with other rheumatic conditions, prevalence was 3·9% for self-reported RA, 1·9% based on the medication database definition and 0·5% by self-reported medication definition. This confirms the overestimation of RA based on self-reporting. We provide an algorithm for identifying individuals with RA, which could be used for population studies and monitoring RA in Australia and, with adjustments, internationally. Its balance of accuracy and practicality will be useful for health service planning using relatively easily accessible input data.

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利用医院和药物数据库监测类风湿关节炎患病率的新方法

对类风湿性关节炎（RA）患病率的大多数估计，包括澳大利亚和许多其他国家的所有官方数字，都是基于自我报告。自我报告已被证明会高估类风湿关节炎的患病率，但审查个人医疗记录这一 "黄金标准 "成本高昂、耗时长，对于大规模研究和人口监测来说并不实用。本研究提供了一种利用行政数据估算RA病例的算法，该算法可根据多种情况进行调整，从而提供澳大利亚首个不依赖自我报告的RA近似队列。澳大利亚妇女健康纵向研究（ALSWH）的25 467名受访者自我报告的RA和药物调查数据与来自国家药物报销数据库、医院和急诊科（ED）病例以及医疗保险福利代码的数据进行了关联。根据自我报告的RA、自我报告的RA药物、配发的RA药物以及医院/急诊科的RA病例计算RA患病率。使用关联数据排除了患有自身免疫性疾病的混杂个体。在 25 467 名调查对象中，1367 名（5-4%）女性自我报告患有疾病。在 26 840 名曾在医院或急诊室就诊的女性中，有 292 人（1-1%）获得了 ICD-10 的 RA 代码。根据药物数据库定义的病例有 1038 例（2-8%），根据自我报告的药物定义的病例有 294 例（1-5%）。排除患有其他风湿病的患者后，自我报告的 RA 患病率为 3-9%，根据药物数据库的定义为 1-9%，根据自我报告的药物定义为 0-5%。这证实了基于自我报告的 RA 患病率被高估。我们提供了一种识别RA患者的算法，可用于澳大利亚的人口研究和RA监测，经调整后也可用于国际研究。该算法兼顾了准确性和实用性，将有助于利用相对容易获取的输入数据进行医疗服务规划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthritis Research & Therapy RHEUMATOLOGY-

CiteScore

8.60

自引率

2.00%

发文量

261

审稿时长

14 weeks

期刊介绍： Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.