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美国人群癫痫的描述性流行病学:一种不同的方法。

Descriptive epidemiology of epilepsy in the U.S. population: A different approach.

作者信息

Helmers Sandra L, Thurman David J, Durgin Tracy L, Pai Akshatha Kalsanka, Faught Edward

机构信息

Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.

UCB Pharma, Smyrna, Georgia, U.S.A.

出版信息

Epilepsia. 2015 Jun;56(6):942-8. doi: 10.1111/epi.13001. Epub 2015 Apr 29.

Abstract

OBJECTIVE

Determine prevalence and incidence of epilepsy within two health insurance claims databases representing large sectors of the U.S.

METHODS

A retrospective observational analysis using Commercial Claims and Medicare (CC&M) Supplemental and Medicaid insurance claims data between January 1, 2007 and December 31, 2011. Over 20 million continuously enrolled lives of all ages were included. Our definition of a prevalent case of epilepsy was based on International Classification of Diseases, Ninth Revision, Clinical Modification-coded diagnoses of epilepsy or seizures and evidence of prescribed antiepileptic drugs. Incident cases were identified among prevalent cases continuously enrolled for ≥ 2 years before the year of incidence determination with no epilepsy, seizure diagnoses, or antiepileptic drug prescriptions recorded.

RESULTS

During 2010 and 2011, overall age-adjusted prevalence estimate, combining weighted estimates from all datasets, was 8.5 cases of epilepsy/1,000 population. With evaluation of CC&M and Medicaid data separately, age-adjusted prevalence estimates were 5.0 and 34.3/1,000 population, respectively, for the same period. The overall age-adjusted incidence estimate for 2011, combining weighted estimates from all datasets, was 79.1/100,000 population. Age-adjusted incidence estimates from CC&M and Medicaid data were 64.5 and 182.7/100,000 enrollees, respectively. Incidence data should be interpreted with caution due to possible misclassification of some prevalent cases.

SIGNIFICANCE

The large number of patients identified as having epilepsy is statistically robust and provides a credible estimate of the prevalence of epilepsy. Our study draws from multiple U.S. population sectors, making it reasonably representative of the U.S.-insured population.

摘要

目的

确定来自代表美国大部分地区的两个医疗保险理赔数据库中癫痫的患病率和发病率。

方法

采用回顾性观察分析,使用2007年1月1日至2011年12月31日期间的商业理赔与医疗保险(CC&M)补充数据和医疗补助保险理赔数据。纳入了超过2000万各年龄段持续参保的人群。我们对癫痫现患病例的定义基于《国际疾病分类,第九版,临床修订本》中编码的癫痫或发作诊断以及开具抗癫痫药物的证据。发病病例是在发病确定年份前连续参保≥2年的现患病例中识别出来的,这些病例之前没有癫痫、发作诊断或抗癫痫药物处方记录。

结果

在2010年和2011年期间,综合所有数据集的加权估计,总体年龄调整患病率估计为每1000人中有8.5例癫痫。分别评估CC&M和医疗补助数据时,同期年龄调整患病率估计分别为每1千人口5.0例和34.3例。2011年综合所有数据集加权估计的总体年龄调整发病率为每10万人79.1例。CC&M和医疗补助数据的年龄调整发病率估计分别为每10万名参保者64.5例和182.7例。由于部分现患病例可能存在错误分类,发病率数据的解释应谨慎。

意义

大量被确定患有癫痫的患者在统计学上具有说服力,为癫痫患病率提供了可靠估计。我们的研究涵盖了美国多个群体,使其能合理地代表美国参保人群。

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