Anger Jennifer T, Dallas Kai B, Bresee Catherine, De Hoedt Amanda M, Barbour Kamil E, Hoggatt Katherine J, Goodman Marc T, Kim Jayoung, Freedland Stephen J
Department of Urology, UC San Diego Health, San Diego, CA, United States.
City of Hope Urology, Duarte, CA, United States.
Front Pain Res (Lausanne). 2022 Aug 24;3:925834. doi: 10.3389/fpain.2022.925834. eCollection 2022.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is an immense burden to both patients and the American healthcare system; it is notoriously difficult to diagnose. Prevalence estimates vary widely (150-fold range in women and >500-fold range in men).
We aimed to create accurate national IC/BPS prevalence estimates by employing a novel methodology combining a national population-based dataset with individual chart abstraction.
In this epidemiological survey, all living patients, with ≥2 clinic visits from 2016 to 2018 in the Veterans Health Administration, with an ICD-9/10 code for IC/BPS ( = 9,503) or similar conditions that may represent undiagnosed IC/BPS ( = 124,331), were identified (other were controls = 5,069,695). A detailed chart review of random gender-balanced samples confirmed the true presence of IC/PBS, which were then age- and gender-matched to the general US population.
Of the 5,203,529 patients identified, IC/BPS was confirmed in 541 of 1,647 sampled charts with an IC/BPS ICD code, 10 of 382 charts with an ICD-like code, and 3 of 916 controls. After age- and gender-matching to the general US population, this translated to national prevalence estimates of 0.87% (95% CI: 0.32, 1.42), with female and male prevalence of 1.08% (95% CI: 0.03, 2.13) and 0.66% (95% CI: 0.44, 0.87), respectively.
We estimate the prevalence of IC/BPS to be 0.87%, which is lower than prior estimates based on survey data, but higher than prior estimates based on administrative data. These potentially represent the most accurate estimates to date, given the broader and more heterogeneous population studied and our novel methodology of combining in-depth chart abstraction with administrative data.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）给患者和美国医疗保健系统都带来了巨大负担；其诊断难度众所周知。患病率估计值差异很大（女性范围为150倍，男性范围超过500倍）。
我们旨在通过采用一种将全国性基于人群的数据集与个体病历摘要相结合的新方法，得出准确的全国IC/BPS患病率估计值。
在这项流行病学调查中，对2016年至2018年在退伍军人健康管理局就诊≥2次的所有在世患者进行了识别，这些患者具有IC/BPS的ICD - 9/10编码（n = 9503）或可能代表未确诊IC/BPS的类似病症（n = 124331），其他患者为对照（n = 5069695）。对随机抽取的性别均衡样本进行详细的病历审查，以确认IC/PBS的真实存在情况，然后将确诊患者按年龄和性别与美国普通人群进行匹配。
在识别出的5203529名患者中，在1647份有IC/BPS ICD编码的抽样病历中有541例确诊为IC/BPS，在382份有类似ICD编码的病历中有10例确诊，在916名对照中有3例确诊。在按年龄和性别与美国普通人群匹配后，这转化为全国患病率估计值为0.87%（95%置信区间：0.32，1.42），女性患病率为1.08%（95%置信区间：0.03，2.13），男性患病率为0.66%（95%置信区间：0.44，0.87）。
我们估计IC/BPS的患病率为0.87%，低于基于调查数据的先前估计值，但高于基于行政数据的先前估计值。鉴于所研究的人群更广泛且更具异质性，以及我们将深入的病历摘要与行政数据相结合的新方法，这些可能是迄今为止最准确的估计值。
