Ostbye Truls, Taylor Donald H, Clipp Elizabeth C, Scoyoc Lynn Van, Plassman Brenda L
Department of Community and Family Medicine, Duke University Center for Health Policy, School of Nursing, Duke University Medical Center, Box 2914 Med Ctr, Durham, NC 27710, USA.
Health Serv Res. 2008 Feb;43(1 Pt 1):313-26. doi: 10.1111/j.1475-6773.2007.00748.x.
To estimate the proportion of seniors with dementia from three independent data sources and their agreement.
The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certificate data.
Estimates of the proportion of individuals with dementia from: (1) self- or proxy-reported cognitive status measures from surveys, (2) Medicare claims, and (3) death certificates. Agreement using Cohen's kappa; multivariate logistic regression.
The proportion varied substantially among the data sources. Agreement was poor (kappa: 0.14-0.46 depending upon comparison assessed); the individuals identified had relatively modest overlap.
Estimates of dementia occurrence based on cognitive status measures from three independent data sources were not interchangeable. Further validation of these sources is needed. Caution should be used if policy is based on only one data source.
从三个独立数据源估计老年痴呆症患者的比例及其一致性。
老年纵向资产与健康动态（AHEAD）研究（n = 7,974）、医疗保险理赔数据和死亡证明数据。
通过以下方式估计痴呆症患者比例：（1）调查中自我或代理人报告的认知状态测量；（2）医疗保险理赔数据；（3）死亡证明。使用科恩kappa系数评估一致性；进行多变量逻辑回归分析。
各数据源之间的比例差异很大。一致性较差（kappa系数：0.14 - 0.46，取决于评估的比较情况）；所识别出的个体重叠程度相对较小。
基于三个独立数据源的认知状态测量对痴呆症发生率的估计不可相互替换。需要对这些数据源进行进一步验证。如果政策仅基于单一数据源制定，应谨慎行事。
