Selçuk Halit, Roos Ewa M, Grønne Dorte T, Ernst Martin T, Skou Søren T
Department of Physiotherapy and Rehabilitation, Marmara University, İstanbul, Turkey.
Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Clin Epidemiol. 2021 Aug 30;13:779-790. doi: 10.2147/CLEP.S309364. eCollection 2021.
To validate self-reported information obtained from patients with knee or hip osteoarthritis (OA) in primary care against administrative data from the three national Danish registries.
We compared the baseline and 12-month follow-up data from 38,745 patients with knee or hip OA participating in the Good Life with osteoArthritis in Denmark (GLA:D) program with registry-based data on joint surgeries, pain medication dispensing, radiographs, and hospital diagnoses. Agreement was calculated using Cohen's Kappa (k) and percentage agreement, both with 95% CI.
There was a moderate agreement between self-report and registry-based data for previous knee surgery (k=0.58, 84.99%) and a substantial agreement for previous hip surgery (k=0.73, 97.05%). Agreement varied from 0.05 to 0.95 and 84.99% to 99.94% for different types of surgeries with lowest agreement for collateral ligament surgery (k=0.05, 99.82%) and highest agreement for joint replacement (k=0.95, 99.54% for knee; k=0.95, 99.48% for hip). There was a moderate agreement (k=0.41, 81.59%) for knee and a slight agreement (k=0.20, 64.79%) for hip radiographs. Agreement varied from 0.01 to 0.53 and 65.39% to 99.90% for pain medication with lowest agreement for topical NSAID (k=0.01, 95.00%) and highest agreement for opioids (k=0.53, 92.56%). For comorbidities, agreement varied from 0.14 to 0.90 and 78.07% to 98.91%, with lowest agreement for anemia or other blood disease (k=0.14, 97.63%) and highest agreement for diabetes (k=0.90, 98.73%).
As the most common types of pain medication used by patients with OA can be bought over-the-counter and as most OA patients are treated in primary care, which is often not covered by national registries, self-report of pain medication use and comorbidities is preferred but cannot be sufficiently validated against registry-based data. Future studies collecting self-reported information on joint surgery and pain medication from patients with OA should use a less detailed categorization to improve accuracy.
对照丹麦三个国家登记处的行政数据,验证从基层医疗中膝或髋骨关节炎(OA)患者处获取的自我报告信息。
我们将参与丹麦骨关节炎美好生活(GLA:D)项目的38745例膝或髋OA患者的基线数据和12个月随访数据,与基于登记处的关节手术、止痛药物配给、X光片及医院诊断数据进行了比较。使用Cohen's Kappa(κ)和百分比一致性计算一致性,并给出95%置信区间。
既往膝关节手术的自我报告与基于登记处的数据之间存在中度一致性(κ=0.58,84.99%),既往髋关节手术存在高度一致性(κ=0.73,97.05%)。不同类型手术的一致性在0.05至0.95之间,百分比一致性在84.99%至99.94%之间,侧副韧带手术的一致性最低(κ=0.05,99.82%),关节置换的一致性最高(膝关节κ=0.95,99.54%;髋关节κ=0.95,99.48%)。膝关节X光片存在中度一致性(κ=0.41,81.59%),髋关节X光片存在低度一致性(κ=0.20,64.79%)。止痛药物的一致性在0.01至0.53之间,百分比一致性在65.39%至99.90%之间,外用非甾体抗炎药的一致性最低(κ=0.01,95.00%),阿片类药物的一致性最高(κ=0.53,92.56%)。对于合并症,一致性在0.14至0.90之间,百分比一致性在78.07%至98.91%之间,贫血或其他血液疾病的一致性最低(κ=0.14,97.63%),糖尿病的一致性最高(κ=0.90,98.73%)。
由于OA患者使用的最常见类型的止痛药物可以在柜台购买,且大多数OA患者在基层医疗中接受治疗,而国家登记处通常未涵盖基层医疗,因此止痛药物使用和合并症的自我报告是可取的,但无法对照基于登记处的数据进行充分验证。未来从OA患者中收集关于关节手术和止痛药物的自我报告信息的研究,应采用不太详细的分类方法以提高准确性。