Cisternas Miriam G, Murphy Louise, Sacks Jeffrey J, Solomon Daniel H, Pasta David J, Helmick Charles G
MGC Data Services, Carlsbad, California.
Centers for Disease Control and Prevention, Atlanta, Georgia.
Arthritis Care Res (Hoboken). 2016 May;68(5):574-80. doi: 10.1002/acr.22721.
Provide a contemporary estimate of osteoarthritis (OA) by comparing the accuracy and prevalence of alternative definitions of OA.
The Medical Expenditure Panel Survey (MEPS) household component (HC) records respondent-reported medical conditions as open-ended responses; professional coders translate these responses into International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for the medical conditions files. Using these codes and other data from the MEPS-HC medical conditions files, we constructed 3 case definitions of OA and assessed them against medical provider diagnoses of ICD-9-CM 715 (osteoarthrosis and allied disorders) in a MEPS subsample. The 3 definitions were 1) strict = ICD-9-CM 715; 2) expanded = ICD-9-CM 715, 716 (other and unspecified arthropathies) OR 719 (other and unspecified disorders of joint); and 3) probable = strict OR expanded + respondent-reported prior diagnosis of OA or other arthritis excluding rheumatoid arthritis.
Sensitivity and specificity of the 3 definitions, respectively, were 34.6% and 97.5% for strict, 73.8% and 90.5% for expanded, and 62.9% and 93.5% for probable.
The strict definition for OA (ICD-9-CM 715) excludes many individuals with OA. The probable definition of OA has the optimal combination of sensitivity and specificity relative to the 2 other MEPS-based definitions and yields a national annual estimate of 30.8 million adults with OA (13.4% of US adult population) for 2008-2011.
通过比较骨关节炎（OA）替代定义的准确性和患病率，提供对OA的当代评估。
医疗支出小组调查（MEPS）家庭部分（HC）将受访者报告的医疗状况记录为开放式回答；专业编码人员将这些回答转换为《国际疾病分类，第九次修订本，临床修订版》（ICD-9-CM）代码，用于医疗状况文件。利用这些代码和来自MEPS-HC医疗状况文件的其他数据，我们构建了3种OA病例定义，并在MEPS子样本中根据医疗服务提供者对ICD-9-CM 715（骨关节炎及相关疾病）的诊断对其进行评估。这3种定义分别为：1）严格定义 = ICD-9-CM 715；2）扩展定义 = ICD-9-CM 715、716（其他和未特指的关节病）或719（关节的其他和未特指的疾病）；3）可能定义 = 严格定义或扩展定义 + 受访者报告的既往OA或其他非类风湿性关节炎的关节炎诊断。
这3种定义的敏感性和特异性分别为：严格定义为34.6%和97.5%，扩展定义为73.8%和90.5%，可能定义为62.9%和93.5%。
OA的严格定义（ICD-9-CM 715）排除了许多OA患者。相对于其他两种基于MEPS的定义，OA的可能定义在敏感性和特异性方面具有最佳组合，并得出2008 - 2011年美国每年有3080万成年人患有OA（占美国成年人口的13.4%）的全国估计数。
