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以患者记录作为参考标准,丹麦国家患者登记处中50岁及以上个体炎性肠病诊断编码的阳性预测值。

Positive Predictive Value of Diagnostic Codes for Inflammatory Bowel Disease in the Danish National Patient Registry Among Individuals 50+ Years, Using Patient Records as Reference Standard.

作者信息

Rye Camilla, Rubin Katrine Hass, Moller Frederik Trier, Julsgaard Mette, Jess Tine, Andersen Vibeke

机构信息

Research Unit for Molecular Diagnostics and Clinical Research, Institute for Regional Health Research-Center of Southern Jutland, University Hospital of Southern Denmark, Aabenraa, Denmark.

OPEN - Open Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark.

出版信息

Clin Epidemiol. 2021 May 24;13:335-344. doi: 10.2147/CLEP.S298770. eCollection 2021.

Abstract

PURPOSE

Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic diseases. The aim was to validate diagnoses of IBD among patients aged 50+ years in the Danish National Patient Registry (NPR) by comparison with patient medical records.

PATIENTS AND METHODS

Men and women in the Diet, Cancer and Health (DCH) cohort were linked to NPR, and cases with a diagnosis of IBD and their respective hospital records were identified. Validation was performed by comparing patient medical records with information on discharge diagnoses of IBD from the NPR.

RESULTS

Of 57,053 individuals in the DCH-cohort, 339 were registered with an IBD diagnosis in NPR, with 277 (82%) records available for review. Among 277 patients, the positive predictive values (PPVs) of one CD or UC registration in NPR were 78% for IBD overall, 51% for CD and 54% for UC. One hundred fifty-seven patients had at least two CD and/or UC registrations with PPVs of 90% for IBD overall, 65% for CD and 73% for UC. One hundred and two patients had at least three registrations with PPVs of 97% for IBD overall, 75% for CD and 88% for UC. 96% were diagnosed at a specialized department. Other diagnoses coded as IBD mostly included microscopic colitis, irritable bowel syndrome and cancer.

CONCLUSION

Validity of IBD diagnoses in the registry of individuals aged 50+ years increased with the number of registrations. It is recommended that these results are taken into consideration in future studies, especially in epidemiology research using NPR as a data source for patients diagnosed with IBD.

摘要

目的

炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),是慢性疾病。目的是通过与患者病历进行比较,验证丹麦国家患者登记处(NPR)中50岁及以上患者的IBD诊断。

患者与方法

饮食、癌症与健康(DCH)队列中的男性和女性与NPR建立了关联,并确定了诊断为IBD的病例及其各自的医院记录。通过将患者病历与NPR中IBD出院诊断信息进行比较来进行验证。

结果

在DCH队列的57053名个体中,有339人在NPR中登记了IBD诊断,其中277份(82%)记录可供审查。在277名患者中,NPR中一次CD或UC登记的阳性预测值(PPV)对于总体IBD为78%,对于CD为51%,对于UC为54%。157名患者至少有两次CD和/或UC登记,总体IBD的PPV为90%,CD为65%,UC为73%。102名患者至少有三次登记,总体IBD的PPV为97%,CD为75%,UC为88%。96%是在专科部门诊断的。其他编码为IBD的诊断大多包括显微镜下结肠炎、肠易激综合征和癌症。

结论

50岁及以上个体登记处中IBD诊断的有效性随着登记次数的增加而提高。建议在未来的研究中考虑这些结果,特别是在将NPR作为诊断IBD患者数据源的流行病学研究中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9206/8164354/b9717493d8e7/CLEP-13-335-g0001.jpg

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