School of Public Health, University of Haifa, Israel.
J Parkinsons Dis. 2011;1(1):35-47. doi: 10.3233/JPD-2011-11024.
Estimating rates of Parkinson's disease (PD) is essential for health services planning and studies of disease determinants. However, few PD registries exist. We aimed to estimate annual prevalence and incidence of PD in a large Israeli population over the past decade using computerized drug purchase data. Based on profiles of anti-parkinsonian drugs, age at first purchase, purchase density, and follow-up time, we developed a refined algorithm for PD assessment (definite, probable or possible) and validated it against clinical diagnoses. We used the prescription database of the second largest Health Maintenance Organization in Israel (covers ~25% of population), for the years 1998-2008. PD rates by age, gender and year were calculated and compared using Poisson models. The algorithm was found to be highly sensitive (96%) for detecting PD cases. We identified 7,134 prevalent cases (67% definite/probable), and 5,288 incident cases (65% definite/probable), with mean age at first purchase 69 ± 13 years. Over the years 2000-2007, PD incidence rate of 33/100,000 was stable, and the prevalence rate increased from 170/100,000 to 256/100,000. For ages 50+, 60+, 70+, median prevalence rates were 1%, 2%, 3%, respectively. Incidence rates also increased with age (RR = 1.76, 95%CI 1.75-1.77, ages 50+, 5-year interval). For ages 50+, rates were higher among men for both prevalence (RR = 1.38, 95%CI 1.37-1.39) and incidence (RR = 1.45, 95%CI 1.42-1.48). In conclusion, our refined algorithm for PD assessment, based on computerized drug purchases data, may be a reliable tool for population-based studies. The findings indicate a burden of PD in Israel higher than previously assumed.
估计帕金森病 (PD) 的发病率对于卫生服务规划和疾病决定因素的研究至关重要。然而，目前存在的 PD 登记处很少。我们旨在使用计算机化药物购买数据，估算过去十年中以色列一个大型人群中的 PD 年患病率和发病率。基于抗帕金森药物的特征、首次购买年龄、购买密度和随访时间，我们开发了一种用于 PD 评估（明确、可能或可能）的改良算法，并对其进行了临床诊断验证。我们使用了以色列第二大健康维护组织（覆盖约 25%的人口）的处方数据库，该数据库涵盖了 1998 年至 2008 年的数据。使用泊松模型计算了按年龄、性别和年份计算的 PD 发生率，并进行了比较。该算法对 PD 病例的检测具有很高的敏感性（96%）。我们确定了 7134 例现患病例（67%明确/可能）和 5288 例新发病例（65%明确/可能），首次购买的平均年龄为 69±13 岁。在 2000 年至 2007 年期间，PD 的发病率为 33/100,000，患病率从 170/100,000 增加到 256/100,000。对于 50 岁以上的人群，中位数患病率分别为 1%、2%和 3%。发病率也随着年龄的增长而增加（RR=1.76，95%CI 1.75-1.77，50 岁以上，5 年间隔）。对于 50 岁以上的人群，患病率在男性中均较高（RR=1.38，95%CI 1.37-1.39）和发病率（RR=1.45，95%CI 1.42-1.48）。总之，我们基于计算机化药物购买数据的 PD 评估改良算法可能是一种可靠的基于人群的研究工具。这些发现表明，以色列的 PD 负担高于之前的假设。
