Endocrinology and Nutrition Department Hospital Sant Joan Despí Moisès Broggi Sant Joan Despi Spain.
Endocrinology and Nutricion Department Hospital Germans Trias I Pujol Badalona Spain.
Endocrinol Diabetes Metab. 2020 Jul 8;4(1):e00167. doi: 10.1002/edm2.167. eCollection 2021 Jan.
Population studies on the prevalence of thyroid dysfunctions are costly. The pharmacy dispensing (PDR) and diagnosis (DR) registers allow us to study the epidemiology of these pathologies in a simpler way. Our aims: 1/Estimate the prevalence of thyroid dysfunction in Catalonia based on data from the PDR and the DR, 2/to evaluate the concordance of the results obtained by both strategies.
The population studied was the one registered with the public health system in Catalonia(Catsalut). In the PDR analysis, the information obtained through the Pharmaceutical Provision file (during 2012, 2013, 2014) was used regarding the number of patients under treatment (NPT) (levothyroxine and antithyroid medication). The DR analysis (2014) was performed by ICD-9 codes (hyperthyroidism 242 and hypothyroidism 243, 244).
According to the NPT in the PDR analysis, the prevalence of treated hypothyroidism increased over 3 years: 2.81%(2012), 2.92%(2013) and 3.07%(2014) ( < .00001). The prevalence of hyperthyroidism in treatment was 0.14%(2012), 0.13%(2013) and 0.14%(2014). According to the DR analysis in 2014, the prevalence of hypothyroidism was 2.54% and 0.35% for hyperthyroidism. The PDR analysis estimated a higher hypothyroidism prevalence compared to that estimated by the DR ( < .0001) and vice versa in the case of hyperthyroidism.
Both PDR and DR prevalence estimations of thyroid dysfunction show some degree of discordance probably due to undercoding bias in the case of DR and the absence of subclinical pathology in the case of PDR. However, both approaches are valid and complementary for estimating the prevalence of thyroid dysfunction.
人群中甲状腺功能障碍的患病率研究代价高昂。药房配药(PDR)和诊断(DR)登记册使我们能够以更简单的方式研究这些疾病的流行病学。我们的目标:1. 根据 PDR 和 DR 的数据,估计加泰罗尼亚甲状腺功能障碍的患病率;2. 评估两种策略得出的结果的一致性。
研究人群为加泰罗尼亚公共卫生系统(Catsalut)登记的人群。在 PDR 分析中,使用了 2012 年、2013 年和 2014 年期间通过药物供应档案获得的患者治疗人数(NPT)(左甲状腺素和抗甲状腺药物)的信息。DR 分析(2014 年)通过 ICD-9 代码(甲状腺功能亢进症 242 和甲状腺功能减退症 243、244)进行。
根据 PDR 分析中的 NPT,治疗性甲状腺功能减退症的患病率在 3 年内增加:2.81%(2012 年)、2.92%(2013 年)和 3.07%(2014 年)(<.00001)。治疗性甲状腺功能亢进症的患病率为 0.14%(2012 年)、0.13%(2013 年)和 0.14%(2014 年)。根据 2014 年的 DR 分析,甲状腺功能减退症的患病率为 2.54%,甲状腺功能亢进症为 0.35%。与 DR 分析相比,PDR 分析估计的甲状腺功能减退症患病率更高(<.0001),而甲状腺功能亢进症则相反。
PDR 和 DR 对甲状腺功能障碍患病率的估计都存在一定程度的不一致,这可能是由于 DR 中的编码不足偏差和 PDR 中的亚临床病理缺失所致。然而,这两种方法都是有效的,并且对于估计甲状腺功能障碍的患病率是互补的。