比较行政数据、调查、临床试验和队列研究中收集的中风合并症。

Monique F Kilkenny, Lachlan L Dalli, Ailie Sanders, Muideen T Olaiya, Joosup Kim, David Ung, Nadine E Andrew
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引用次数: 0

摘要

背景:行政数据被广泛用于研究目的,但关于这些数据在确定中风相关合并症方面的质量的信息仍然有限:目的:比较使用国际疾病分类澳大利亚修订版(ICD-10-AM)或解剖治疗化学代码确定的中风合并症患病率与(i)自我报告数据和(ii)已发表研究中的合并症患病率:队列包括澳大利亚卒中临床登记处(N = 26,111)的医院收治的卒中或短暂性脑缺血发作患者(2012-2016 年;维多利亚州和昆士兰州)。数据与医院和药品数据集相连接,使用已发布的算法确定合并症。将这些合并症的敏感性、特异性和阳性预测值与 623 名患者的调查反馈(参考标准)进行了比较。同时还与已发表的卒中研究中的临床数据进行了间接比较:除糖尿病(93.0%)外,医院 ICD-10-AM 数据对大多数合并症的灵敏度较低。除高血压(70.5%)外,所有合并症的特异性都很好(87-96%)。与已发表的脑卒中研究(3 项临床试验和 1 项发病率研究)相比,我们队列中的糖尿病和心房颤动患病率与 ICD-10-AM 代码相似,但血脂异常和焦虑/抑郁患病率较低。而在配药数据中,血脂异常的灵敏度极高(94%),焦虑/抑郁的灵敏度一般(77%)。在药品数据中,高血压(78%)和焦虑或抑郁(76%)的特异性一般,但血脂异常(19%)和心脏病(46%)的特异性较差:结论:行政数据中中风合并症的报告存在差异,在研究中可能需要考虑多种数据来源。需要进一步改进行政数据中合并症的编码和临床记录。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of comorbidities of stroke collected in administrative data, surveys, clinical trials and cohort studies.

Background: Administrative data are used extensively for research purposes, but there remains limited information on the quality of these data for identifying comorbidities related to stroke.

Objective: To compare the prevalence of comorbidities of stroke identified using International Classification Diseases, Australian Modification (ICD-10-AM) or Anatomical Therapeutic Chemical codes, with those from (i) self-reported data and (ii) published studies.

Method: The cohort included patients with stroke or transient ischaemic attack admitted to hospitals (2012-2016; Victoria and Queensland) in the Australian Stroke Clinical Registry (N = 26,111). Data were linked with hospital and pharmaceutical datasets to ascertain comorbidities using published algorithms. The sensitivity, specificity, and positive predictive value of these comorbidities were compared with survey responses from 623 patients (reference standard). An indirect comparison was also performed with clinical data from published stroke studies.

Results: The sensitivity of hospital ICD-10-AM data was poor for most comorbidities, except for diabetes (93.0%). Specificity was excellent for all comorbidities (87-96%), except for hypertension (70.5%). Compared to published stroke studies (3 clinical trials and 1 incidence study), the prevalence of diabetes and atrial fibrillation in our cohort was similar using ICD-10-AM codes, but lower for dyslipidaemia and anxiety/depression. Whereas in the pharmaceutical dispensing data, the sensitivity was excellent for dyslipidaemia (94%) and modest for anxiety/depression (77%). In the pharmaceutical data, specificity was modest for hypertension (78%) and anxiety or depression (76%), but specificity was poor for dyslipidaemia (19%) and heart disease (46%).

Conclusion: Variation was observed in the reporting of comorbidities of stroke in administrative data, and consideration of multiple sources of data may be necessary for research. Further work is needed to improve coding and clinical documentation for reporting of comorbidities in administrative data.

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