Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario.
Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Can J Psychiatry. 2020 Feb;65(2):107-114. doi: 10.1177/0706743719844183. Epub 2019 May 2.
Eating disorders are common and have a high public health burden. However, existing clinically relevant data sources are scarce, limiting the capacity to accurately measure the burden of eating disorders. This study tests the feasibility of generating a large clinically relevant cohort of individuals with eating disorders using health administrative data.
We developed 3 clinically relevant eating disorder prevalence cohorts using health administrative data from Ontario, Canada, between 1990 and 2014. Cohort 1 included patients with a hospitalization where an eating disorder diagnosis was the primary diagnosis, cohort 2 included patients with a hospitalization where an eating disorder diagnosis was any diagnosis, and cohort 3 included cohort 2 plus any patient with an emergency department visit with an eating disorder diagnosis.
Cohort 1 had 7268 patients, cohort 2 had 13,197 patients, and cohort 3 had 17,373 patients. As cohort size increased, the proportion of eating disorder patients with diagnoses of bulimia nervosa and eating disorder not otherwise specified increased. Although the cohorts differed according to demographic and clinical characteristics, these differences were small compared to the degree to which they differed from the Ontario population.
It is feasible to use health administrative data to measure the clinically relevant burden of eating disorders. The cohorts differed significantly in the eating disorder diagnostic composition. Eating disorders have a high burden, but poor data availability has resulted in fewer public health-related eating disorders studies in comparison to other mental disorders. The use of administrative data can address this evidence gap.
饮食失调是常见的，对公众健康有很大的负担。然而，现有的临床相关数据来源稀缺，限制了准确衡量饮食失调负担的能力。本研究测试了使用健康管理数据生成大量具有临床相关性的饮食失调患者队列的可行性。
我们使用加拿大安大略省 1990 年至 2014 年期间的健康管理数据，开发了 3 个具有临床相关性的饮食失调患病率队列。队列 1 包括因饮食失调诊断为主要诊断的住院患者，队列 2 包括因饮食失调诊断为任何诊断的住院患者，队列 3 包括队列 2 加上任何因饮食失调诊断而就诊的急诊患者。
队列 1 有 7268 名患者，队列 2 有 13197 名患者，队列 3 有 17373 名患者。随着队列规模的增加，患有神经性贪食症和未特定饮食失调症的饮食失调患者比例增加。尽管队列在人口统计学和临床特征方面存在差异，但与安大略省人群相比，这些差异很小。
使用健康管理数据来衡量具有临床相关性的饮食失调负担是可行的。队列在饮食失调诊断组成方面存在显著差异。饮食失调负担沉重，但由于数据可用性较差，与其他精神障碍相比，公共卫生相关的饮食失调研究较少。使用行政数据可以解决这一证据差距。
