Department of Psychiatry, University of Cambridge, Cambridge, UK.
University of Cambridge, School of Clinical Medicine, Cambridge, UK.
Int J Methods Psychiatr Res. 2022 Dec;31(4):e1926. doi: 10.1002/mpr.1926. Epub 2022 Aug 10.
To explore the impact of various measurements of long-term health conditions (LTCs) on the resulting prevalence estimates using data from a nationally representative dataset.
Children and young people in the Millennium Cohort Study were followed at ages 3, 5, 7, 11, and 14 years (N = 15,631). We estimated the weighted prevalence of LTCs at each time point and examined the degree to which estimates agreed with alternate health indicators (special educational needs and disability [SEND], specific chronic conditions, and common chronicity criteria) using descriptive analyses, Cohen's kappa statistic, and percentage agreement.
The estimated weighted prevalence of LTCs peaked at 5 years old (20%). Despite high percentage agreement, we observed at best moderate chance-corrected agreement between the type of LTC and reasons for SEND (kappas from 0.02 to 0.56, percentage agreement from 97% to 99%) or specified chronic conditions (kappas from 0.002 to 0.02, percentage agreement from 73% to 97%). Applying chronicity criteria decreased the estimated weighted prevalence of LTCs (3%).
How long-term conditions are defined drastically alters the estimated weighted prevalence of LTCs. Improved clarity and consistency in the definition and measurement of LTCs is urgently needed to underpin policy and commissioning of services.
利用来自全国代表性数据集的数据，探讨各种长期健康状况（LTC）测量对结果患病率估计的影响。
千禧年队列研究中的儿童和年轻人在 3、5、7、11 和 14 岁时（N=15631）进行随访。我们估计了每个时间点 LTC 的加权患病率，并使用描述性分析、Cohen's kappa 统计量和百分比一致性来检查替代健康指标（特殊教育需求和残疾[SEND]、特定慢性疾病和常见慢性标准）的估计值与这些指标的一致性程度。
LTC 的估计加权患病率在 5 岁时达到峰值（20%）。尽管百分比一致性很高，但我们观察到 LTC 类型与SEND（kappa 值为 0.02 至 0.56，百分比一致性为 97%至 99%）或特定慢性疾病（kappa 值为 0.002 至 0.02，百分比一致性为 73%至 97%）之间的机会校正一致性最好为中度。应用慢性标准降低了 LTC 的估计加权患病率（3%）。
长期状况的定义方式极大地改变了 LTC 的估计加权患病率。迫切需要明确和统一 LTC 的定义和测量，以支持政策和服务的委托。
