Accuracy of Canadian Health Administrative Databases in Identifying Patients With Rheumatoid Arthritis: A Validation Study Using the Medical Records of Rheumatologists
- 24 September 2013
- journal article
- research article
- Published by Wiley in Arthritis Care & Research
- Vol. 65 (10), 1582-1591
- https://doi.org/10.1002/acr.22031
Abstract
Objective Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada. Methods We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist‐reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data. Results One hundred forty‐nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94–100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of “(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with ≥1 by a specialist in a 2‐year period)” had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date. Conclusion We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance.This publication has 24 references indexed in Scilit:
- Systematic Review and Critical Appraisal of Validation Studies to Identify Rheumatic Diseases in Health Administrative DatabasesArthritis Care & Research, 2013
- Tradeoffs between accuracy measures for electronic health care data algorithmsJournal of Clinical Epidemiology, 2012
- Validation of rheumatoid arthritis diagnoses in health care utilization dataArthritis Research & Therapy, 2011
- Quality care in seniors with new‐onset rheumatoid arthritis: A Canadian perspectiveArthritis Care & Research, 2010
- Health care utilization for musculoskeletal disordersArthritis Care & Research, 2010
- How accurate are diagnoses for rheumatoid arthritis and juvenile idiopathic arthritis in the general practice research database?Arthritis Care & Research, 2008
- Gaps in care for rheumatoid arthritis: A population studyArthritis Care & Research, 2005
- Accuracy of veterans administration databases for a diagnosis of rheumatoid arthritisArthritis Care & Research, 2004
- The sensitivity and specificity of computerized databases for the diagnosis of rheumatoid arthritisArthritis & Rheumatism, 1994
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988