The use of administrative health care databases to identify patients with Rheumatoid Arthritis

Hanly, John G, Thompson, Kara and Skedgel, Chris ORCID: (2015) The use of administrative health care databases to identify patients with Rheumatoid Arthritis. Open Access Rheumatology: Research and Reviews, 7. pp. 69-75. ISSN 1179-156X

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Objective: To validate and compare the decision rules to identify rheumatoid arthritis (RA) in administrative databases. Methods: A study was performed using administrative health care data from a population of 1 million people who had access to universal health care. Information was available on hospital discharge abstracts and physician billings. RA cases in health administrative databases were matched 1:4 by age and sex to randomly selected controls without inflammatory arthritis. Seven case definitions were applied to identify RA cases in the health administrative data, and their performance was compared with the diagnosis by a rheumatologist. The validation study was conducted on a sample of individuals with administrative data who received a rheumatologist consultation at the Arthritis Center of Nova Scotia. Results: We identified 535 RA cases and 2,140 non-RA, noninflammatory arthritis controls. Using the rheumatologist's diagnosis as the gold standard, the overall accuracy of the case definitions for RA cases varied between 68.9% and 82.9% with a kappa statistic between 0.26 and 0.53. The sensitivity and specificity varied from 20.7% to 94.8% and 62.5% to 98.5%, respectively. In a reference population of 1 million, the estimated annual number of incident cases of RA was between 176 and 1,610 and the annual number of prevalent cases was between 1,384 and 5,722. Conclusion: The accuracy of case definitions for the identification of RA cases from rheumatology clinics using administrative health care databases is variable when compared to a rheumatologist's assessment. This should be considered when comparing results across studies. This variability may also be used as an advantage in different study designs, depending on the relative importance of sensitivity and specificity for identifying the population of interest to the research question.

Item Type: Article
Uncontrolled Keywords: inflammatory arthritis,case definitions,incidence,prevalence,population health
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research
Depositing User: Pure Connector
Date Deposited: 19 Nov 2015 17:00
Last Modified: 21 Oct 2022 02:31
DOI: 10.2147/OARRR.S92630

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