Lasota A N, Overvad K, Eriksen H H, Tjønneland A, Schmidt E B, Grønholdt M-L M
Department of Vascular Surgery, Aalborg University Hospital, Aalborg, Denmark.
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
Eur J Vasc Endovasc Surg. 2017 May;53(5):679-685. doi: 10.1016/j.ejvs.2016.12.031. Epub 2017 Feb 7.
OBJECTIVES/BACKGROUND: The objective was to validate the diagnoses of peripheral arterial disease (PAD) in the legs, obtained from national registers in Denmark.
In total, 1435 registered cases of PAD were identified in the Danish National Patient Registry among 57,053 middle aged participants from the Danish Diet, Cancer and Health cohort study. Validation was performed by reviewing all medical records using pre-specified criteria for a diagnosis of PAD.
The overall positive predictive value (PPV) of PAD diagnoses was 69.4% [95% confidence interval (CI) 67.0-71.7]. The PPV of diagnoses given in departments of vascular surgery was significantly higher than diagnoses given in other departments: 71.9% (95% CI 69.2-74.4) versus 58.3% (95% CI 52.2-64.2), respectively. In a sub-study, 141 potential cases of PAD also registered in the Danish National Vascular Registry were evaluated, and a PPV of 87.9% (95% CI 81.4-92.4) was found for these diagnoses.
More than 30% of the diagnoses of PAD notified in the Danish National Patient Registry were not valid, stressing the importance of validation when using register information for research purposes. In contrast, diagnoses obtained from the Danish National Vascular Registry had a high validity ready for use without further validation.
目的/背景:目的是验证从丹麦国家登记处获取的腿部外周动脉疾病(PAD)诊断。
在丹麦饮食、癌症与健康队列研究的57053名中年参与者中,丹麦国家患者登记处共识别出1435例登记的PAD病例。通过使用预先指定的PAD诊断标准审查所有医疗记录来进行验证。
PAD诊断的总体阳性预测值(PPV)为69.4%[95%置信区间(CI)67.0 - 71.7]。血管外科给出的诊断的PPV显著高于其他科室给出的诊断:分别为71.9%(95%CI 69.2 - 74.4)和58.3%(95%CI 52.2 - 64.2)。在一项子研究中,对丹麦国家血管登记处也登记的141例潜在PAD病例进行了评估,这些诊断的PPV为87.9%(95%CI 81.4 - 92.4)。
丹麦国家患者登记处通报的PAD诊断中超过30%无效,这凸显了在将登记信息用于研究目的时进行验证的重要性。相比之下,从丹麦国家血管登记处获得的诊断具有很高的有效性,无需进一步验证即可使用。