Development and Validation of an Administrative Case Definition for Inflammatory Bowel Diseases
Open Access
- 1 January 2012
- journal article
- research article
- Published by Hindawi Limited in Canadian Journal of Gastroenterology
- Vol. 26 (10), 711-717
- https://doi.org/10.1155/2012/278495
Abstract
BACKGROUND: A population-based database of inflammatory bowel disease (IBD) patients is invaluable to explore and monitor the epidemiology and outcome of the disease. In this context, an accurate and validated population-based case definition for IBD becomes critical for researchers and health care providers.METHODS: IBD and non-IBD individuals were identified through an endoscopy database in a western Canadian health region (Calgary Health Region, Calgary, Alberta). Subsequently, using a novel algorithm, a series of case definitions were developed to capture IBD cases in the administrative databases. In the second stage of the study, the criteria were validated in the Capital Health Region (Edmonton, Alberta).RESULTS: A total of 150 IBD case definitions were developed using 1399 IBD patients and 15,439 controls in the development phase. In the validation phase, 318,382 endoscopic procedures were searched and 5201 IBD patients were identified. After consideration of sensitivity, specificity and temporal stability of each validated case definition, a diagnosis of IBD was assigned to individuals who experienced at least two hospitalizations or had four physician claims, or two medical contacts in the Ambulatory Care Classification System database with an IBD diagnostic code within a two-year period (specificity 99.8%; sensitivity 83.4%; positive predictive value 97.4%; negative predictive value 98.5%). An alternative case definition was developed for regions without access to the Ambulatory Care Classification System database. A novel scoring system was developed that detected Crohn disease and ulcerative colitis patients with a specificity of >99% and a sensitivity of 99.1% and 86.3%, respectively.CONCLUSION: Through a robust methodology, a reproducible set of criteria to capture IBD patients through administrative databases was developed. The methodology may be used to develop similar administrative definitions for chronic diseases.Keywords
This publication has 22 references indexed in Scilit:
- Can we use the pharmacy data to estimate the prevalence of chronic conditions? a comparison of multiple data sourcesBMC Public Health, 2011
- Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influencesGastroenterology, 2004
- Diabetes in OntarioDiabetes Care, 2002
- Self-Reported Awareness and Use ofInternational Classification of DiseaseCoding of Inflammatory Bowel Disease Services by Ontario PhysiciansCanadian Journal of Gastroenterology, 2002
- Inflammatory bowel disease: epidemiology and management in an English general practice populationAlimentary Pharmacology & Therapeutics, 2000
- Crohn's disease among ethnic groups in a large health maintenance organizationGastroenterology, 1992
- An epidemiologic study of inflammatory bowel disease in Rochester, New YorkGastroenterology, 1990
- Epidemiology of inflammatory bowel disease in a defined northern California population.1988
- Discriminant Function Analysis to Calculate a Crohn??s Activity Group Scale to Predict Future Inactive or Active DiseaseJournal of Clinical Gastroenterology, 1988
- A comparison of medical record with billing diagnostic information associated with ambulatory medical care.American Journal of Public Health, 1981