Moth Grete, Vedsted Peter, Schiøtz Po
Danish Paediatric Asthma Centre, Aarhus University Hospital - Skejby Sygehus, Aarhus N, Denmark.
Eur J Clin Pharmacol. 2007 Jun;63(6):605-11. doi: 10.1007/s00228-007-0286-4. Epub 2007 Mar 27.
The aim of the study was to develop and validate a method for identifying asthmatic children between 6 and 14 years of age based on prescription data on anti-asthmatic drugs and diagnostic data.
A register-based study of 125,907 Danish children aged 6-14 years identified 9695 children who had redeemed at least one anti-asthmatic drug prescription in 2002. The asthma diagnosis in these children was validated by discharge information and by a questionnaire completed by general practitioners. Models based on combinations of different types of drugs were tested to find the best model that would include as many children as possible with a validated diagnosis and exclude as many false positives as possible. Different time windows were tested in terms of detecting the children and the observation period of refilling prescriptions.
The highest specificity of 0.86 [95% confidence interval (95% CI): 0.84-0.87] together with a sensitivity of 0.63 (95% CI: 0.62-0.65) were found in the model that included children who had redeemed a prescription for any anti-asthmatic drug - with the exception of prescriptions for beta2-agonists as liquid, one prescription only of inhaled beta2-agonist or an inhaled steroid - during a 12-month period. Lengthening the observation time by 6 months did not significantly improve the specificity (0.87; 95% CI: 0.85-0.88), but it did result in a statistically significantly lower sensitivity (0.59; 95% CI: 0.58-0.60).
Register-based data on redeemed prescriptions can be utilised to identify asthmatic school children. This method will be useful in health services research and in the proactive care of asthmatic children.
本研究旨在开发并验证一种基于抗哮喘药物处方数据和诊断数据来识别6至14岁哮喘儿童的方法。
一项基于登记册的研究对125,907名6至14岁的丹麦儿童进行了调查，确定了2002年至少兑换过一张抗哮喘药物处方的9695名儿童。这些儿童的哮喘诊断通过出院信息和全科医生填写的问卷进行了验证。对基于不同类型药物组合的模型进行了测试，以找到最佳模型，该模型应尽可能多地纳入经证实诊断的儿童，并尽可能多地排除假阳性。对不同的时间窗口在检测儿童和重新开处方的观察期方面进行了测试。
在包含在12个月期间兑换过任何抗哮喘药物处方（不包括液体β2激动剂处方、仅一张吸入性β2激动剂处方或吸入性类固醇处方）的儿童的模型中，发现特异性最高为0.86 [95%置信区间（95%CI）：0.84 - 0.87]，敏感性为0.63（95%CI：0.62 - 0.65）。将观察时间延长6个月并没有显著提高特异性（0.87；95%CI：0.85 - 0.88），但确实导致敏感性在统计学上显著降低（0.59；95%CI：0.58 - 0.60）。
基于登记册的已兑换处方数据可用于识别哮喘学龄儿童。该方法将有助于卫生服务研究和哮喘儿童的主动护理。
