Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
InGef - Institute for Applied Health Research Berlin, Berlin, Germany.
Neuroepidemiology. 2017;49(3-4):91-98. doi: 10.1159/000481990. Epub 2017 Nov 14.
Data on the incidence of multiple sclerosis (MS) on the national level is scarce. We aimed to estimate the incidence of MS in Germany and to compare different MS case definitions based on claims data.
We conducted a cohort study with the German Pharmacoepidemiological Research Database in 2012 and calculated age- and gender-standardized incidence rates (sIRs) for 3 case definitions. In addition, the effect of stepwise reduction of the look-back period without MS diagnosis on the incidence rate was evaluated.
Our cohort comprised 4,175,877 individuals. The first case definition based on ICD-10 diagnoses yielded an sIR of 21.8 (95% CI 20.2-23.5) per 100,000 person years, whereas the second and third case definitions with additional requirements for drug treatment and diagnostic tests resulted in lower sIRs of 10.1 (9.1-11.3) and 6.6 (5.8-7.6) respectively. We observed a higher incidence for shorter look-back periods.
The incidence of MS in Germany might be substantially higher than suggested in earlier studies. In addition, our study highlights the importance of a look-back period of at least 36 months to identify incident MS cases based on claims data.
关于多发性硬化症（MS）在全国范围内的发病率数据很少。我们旨在估计德国 MS 的发病率，并比较基于索赔数据的不同 MS 病例定义。
我们在 2012 年进行了一项队列研究，使用德国药物流行病学研究数据库，计算了 3 种病例定义的年龄和性别标准化发病率（sIR）。此外，还评估了逐步减少无 MS 诊断的回溯期对发病率的影响。
我们的队列包括 4175877 人。基于 ICD-10 诊断的第一个病例定义得出的 sIR 为每 100,000 人年 21.8（95%CI 20.2-23.5），而第二个和第三个病例定义分别需要药物治疗和诊断测试的额外要求，导致较低的 sIR 分别为 10.1（9.1-11.3）和 6.6（5.8-7.6）。我们观察到回溯期越短，发病率越高。
德国 MS 的发病率可能远高于早期研究中所表明的。此外，我们的研究强调了至少 36 个月的回溯期对于基于索赔数据识别新发病例的重要性。
