Research Coordinator in the Department of Family Medicine at the University of Alberta in Edmonton.
Professor and Research Chair in Primary Care in the Department of Family Medicine and in the School of Public Health at the University of Alberta, Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta, and Network Director for the Canadian Primary Care Sentinel Surveillance Network in southern Alberta.
Can Fam Physician. 2020 Mar;66(3):e107-e114.
To validate a case definition for speech and language disorders in community-dwelling older adults and to determine the prevalence of speech and language disorders in a primary care population.
This is a combined case definition validation and cross-sectional prevalence study. Chart review was considered the reference standard and was used to estimate prevalence. This study used de-identified electronic medical record data from participating SAPCReN-CPCSSN (Southern Alberta Primary Care Research Network-Canadian Primary Care Sentinel Surveillance Network) primary care clinics.
Southern Alberta.
Men and women aged 55 years and older who had visited a SAPCReN-CPCSSN physician or nurse practitioner at least once in the 2 years before the beginning of the study.
Validation analysis included estimation of sensitivity, specificity, positive predictive value, and negative predictive value. Prevalence was the other main outcome measure.
The prevalence of speech and language disorders within the sample of 1384 patients was 1.2%. The case definition had a favourable specificity (99.9%, 95% CI 99.6% to 100.0%), positive predictive value (75.6%, 95% CI 25.4% to 96.6%), and negative predictive value (99.0%, 95% CI 98.8% to 99.2%). Sensitivity was not sufficient for validity (18.8%, 95% CI 4.05% to 45.6%).
The case definition did not meet an acceptable standard for validity and thus cannot be used for future epidemiologic research. However, owing to the case definition's high positive predictive value, it might be useful for clinical purposes and for cohort studies. Finally, while the case definition did not prove valid, this study has provided a conservative estimate of prevalence (1.2%) given the case definition's high specificity.
验证社区居住的老年人群中言语和语言障碍的病例定义，并确定初级保健人群中言语和语言障碍的患病率。
这是一项病例定义验证和横断面患病率研究的结合。图表审查被认为是参考标准，并用于估计患病率。本研究使用参与 SAPCReN-CPCSSN（南阿尔伯塔初级保健研究网络-加拿大初级保健监测网络）初级保健诊所的去识别电子病历数据。
南阿尔伯塔省。
在研究开始前的 2 年内至少一次就诊于 SAPCReN-CPCSSN 医生或护士从业者的年龄在 55 岁及以上的男性和女性。
验证分析包括估计敏感性、特异性、阳性预测值和阴性预测值。患病率是另一个主要观察指标。
在 1384 名患者的样本中，言语和语言障碍的患病率为 1.2%。该病例定义具有良好的特异性（99.9%，95%CI 99.6%至 100.0%）、阳性预测值（75.6%，95%CI 25.4%至 96.6%）和阴性预测值（99.0%，95%CI 98.8%至 99.2%）。敏感性不足以满足有效性（18.8%，95%CI 4.05%至 45.6%）。
该病例定义不符合有效性的可接受标准，因此不能用于未来的流行病学研究。然而，由于该病例定义具有较高的阳性预测值，因此它可能对临床目的和队列研究有用。最后，尽管该病例定义不具有有效性，但鉴于其高特异性，本研究提供了患病率的保守估计（1.2%）。
