Pitter Gisella, Gnavi Roberto, Romor Pierantonio, Zanotti Renzo, Simonato Lorenzo, Canova Cristina
Dipartimento di scienze cardiologiche, toraciche e vascolari, Università degli studi di Padova.
Servizio sovrazonale di epidemiologia ASL TO3, Regione Piemonte.
Epidemiol Prev. 2017 Mar-Apr;41(2):102-108. doi: 10.19191/EP17.2.P102.029.
to assess the role of four administrative healthcare databases (pathology reports, copayment exemptions, hospital discharge records, gluten-free food prescriptions) for the identification of possible paediatric cases of celiac disease.
population-based observational study with record linkage of administrative healthcare databases. SETTING AND PARTICIPANT S: children born alive in the Friuli Venezia Giulia Region (Northern Italy) to resident mothers in the years 1989-2012, identified using the regional Medical Birth Register.
we defined possible celiac disease as having at least one of the following, from 2002 onward: 1. a pathology report of intestinal villous atrophy; 2. a copayment exemption for celiac disease; 3. a hospital discharge record with ICD-9-CM code of celiac disease; 4. a gluten-free food prescription. We evaluated the proportion of subjects identified by each archive and by combinations of archives, and examined the temporal relationship of the different sources in cases identified by more than one source. RESULT S: out of 962 possible cases of celiac disease, 660 (68.6%) had a pathology report, 714 (74.2%) a copayment exemption, 667 (69.3%) a hospital discharge record, and 636 (66.1%) a gluten-free food prescription. The four sources coexisted in 42.2% of subjects, whereas 30.2% were identified by two or three sources and 27.6% by a single source (16.9% by pathology reports, 4.2% by hospital discharge records, 3.9% by copayment exemptions, and 2.6% by gluten-free food prescriptions). Excluding pathology reports, 70.6% of cases were identified by at least two sources. A definition based on copayment exemptions and discharge records traced 80.5% of the 962 possible cases of celiac disease; whereas a definition based on copayment exemptions, discharge records, and gluten-free food prescriptions traced 83.1% of those cases. The temporal relationship of the different sources was compatible with the typical diagnostic pathway of subjects with celiac disease.
the four sources were only partially consistent. A relevant proportion of all possible cases of paediatric celiac disease were identified exclusively by pathology reports.
评估四个医疗行政数据库（病理报告、共付豁免、医院出院记录、无麸质食品处方）在识别可能的小儿乳糜泻病例中的作用。
基于人群的观察性研究，对医疗行政数据库进行记录链接。
1989 - 2012年在弗留利-威尼斯朱利亚大区（意大利北部）出生且母亲为当地居民的活产儿童，通过地区医疗出生登记册识别。
从2002年起，我们将可能的乳糜泻定义为具有以下至少一项：1. 肠道绒毛萎缩的病理报告；2. 乳糜泻共付豁免；3. 国际疾病分类第九版临床修订本（ICD - 9 - CM）编码为乳糜泻的医院出院记录；4. 无麸质食品处方。我们评估了每个档案以及档案组合所识别出的受试者比例，并研究了多个来源识别出的病例中不同来源之间的时间关系。
在962例可能的乳糜泻病例中，660例（68.6%）有病理报告，714例（74.2%）有共付豁免，667例（69.3%）有医院出院记录，636例（66.1%）有无麸质食品处方。42.2%的受试者四个来源同时存在，而30.2%由两个或三个来源识别，27.6%由单一来源识别（16.9%由病理报告识别，4.2%由医院出院记录识别，3.9%由共付豁免识别，2.6%由无麸质食品处方识别）。排除病理报告后，70.6%的病例由至少两个来源识别。基于共付豁免和出院记录的定义追踪到了962例可能的乳糜泻病例中的80.5%；而基于共付豁免、出院记录和无麸质食品处方的定义追踪到了这些病例中的83.1%。不同来源的时间关系与乳糜泻患者的典型诊断途径相符。
这四个来源仅部分一致。所有可能的小儿乳糜泻病例中有相当一部分仅通过病理报告被识别出来。
