Migliore Enrica, Bugiani Massimiliano, Piccioni Pavilio, Galassi Claudia, Balzi Daniela, Barchielli Alessandro, Tessari Roberta, Canova Cristina, Simonato Lorenzo
Servizio di epidemiologia dei tumori, ASO S. Giovanni Battista, CPO Piemonte e Università di Torino.
Epidemiol Prev. 2008 May-Jun;32(3 Suppl):66-77.
development of an algorithm to estimate the prevalence of obstructive lung diseases (OLD) through record linkage of administrative health data sources in three Italian areas.
AULSS 12 Veneziana, city of Torino, ASL10 Firenze.
all residents in the three areas in the period 2002-2004 (N = 1,944,471 on 30th June 2003).
crude prevalence, standardized prevalence with 95% confidence intervals.
the following data sources were used to identify OLD cases: hospital discharges (HD), health-tax exemptions (HTE), death causes (DC) and drug prescriptions (DP). All patients diagnosed with (from HD) or dead because of chronic bronchitis, emphysema and asthma have been included in the analysis. We defined as a prevalent case a subject found in each year in at least one of the four data sources. We reported the absolute and relative contribution of each information system by area, age, gender and year of interest. We performed a sensitivity analysis using more restrictive criteria to identify prevalent cases (two or more DPs per year).
DP was the most relevantsource in identifying cases (from 86 to 88%). The relative contribution ofHD ranged from 3 to 5%. In 2003, standardized prevalence of OLD ranged from 5.35% in Firenze to 6.02% in Venezia. Venezia showed a higher prevalence in children aged 0-14years and a lower prevalence in older age groups (> 64 years) compared to other centers. Overall, the prevalence was higher among males. The use of more restrictive criteria in case identification substantially reduces the estimated prevalence, particularly in younger age-groups and to a lesser extent, in older age-groups.
the algorithm provides estimates with differences between centres. The validity of this algorithm (in terms of sensitivity and positive predictive value) needs to be evaluated through further ad hoc studies.
通过对意大利三个地区行政卫生数据源进行记录链接，开发一种算法来估计阻塞性肺疾病（OLD）的患病率。
威尼斯的AULSS 12、都灵市、佛罗伦萨的ASL10。
2002 - 2004年期间这三个地区的所有居民（2003年6月30日时为N = 1,944,471）。
粗患病率、具有95%置信区间的标准化患病率。
使用以下数据源来识别OLD病例：医院出院记录（HD）、健康税豁免（HTE）、死亡原因（DC）和药物处方（DP）。所有被诊断为（根据HD）或因慢性支气管炎、肺气肿和哮喘死亡的患者都纳入了分析。我们将在每年至少在四个数据源之一中被发现的个体定义为现患病例。我们按地区、年龄、性别和感兴趣的年份报告了每个信息系统的绝对和相对贡献。我们使用更严格的标准进行敏感性分析以识别现患病例（每年两份或更多DP）。
DP是识别病例的最相关来源（86%至88%）。HD的相对贡献范围为3%至5%。2003年，OLD的标准化患病率在佛罗伦萨为5.35%，在威尼斯为6.02%。与其他中心相比，威尼斯0 - 14岁儿童的患病率较高，而老年组（> 64岁）的患病率较低。总体而言，男性患病率较高。在病例识别中使用更严格的标准会大幅降低估计的患病率，特别是在较年轻年龄组，在老年组中降低程度较小。
该算法提供的估计值在各中心之间存在差异。此算法的有效性（在敏感性和阳性预测值方面）需要通过进一步的专项研究进行评估。
