痴呆症的识别：全国调查数据、医疗保险理赔记录与死亡证明之间的一致性。
Identification of dementia: agreement among national survey data, medicare claims, and death certificates.
作者信息
Ostbye Truls, Taylor Donald H, Clipp Elizabeth C, Scoyoc Lynn Van, Plassman Brenda L
机构信息
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.
出版信息
Health Serv Res. 2008 Feb;43(1 Pt 1):313-26. doi: 10.1111/j.1475-6773.2007.00748.x.
OBJECTIVE
To estimate the proportion of seniors with dementia from three independent data sources and their agreement.
DATA SOURCES
The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certificate data.
STUDY DESIGN
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.
PRINCIPAL FINDINGS
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.
CONCLUSIONS
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.
目的
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。
数据来源
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。
研究设计
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。
主要发现
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。
结论
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。
Zotero 插件