Baas Diederik J H, Reitsma Jan, Gerwen Lieke van, Vleghaar Jaron, Gehlen Jolanda M L G, Ziedses des Plantes Cathelijne M P, van Basten Jean Paul A, van den Bergh Roderick C N, Bruins H Max, Collette Eelco R P, Hoekstra Robert J, Knipscheer Ben C, van Leeuwen Pim J, Luijendijk-de Bruin Daphne, van Roermund Joep G H, Sedelaar J P Michiel, Speel Tommy G W, Stomps Saskia P, Wijburg Carl J, Wijn Rob P W F, de Jong Igle Jan, Somford Diederik M
Department of Urology, Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands.
Prosper Prostate Cancer Clinics, 6532 SZ Nijmegen, The Netherlands.
Cancers (Basel). 2023 Dec 7;15(24):5740. doi: 10.3390/cancers15245740.
The use of healthcare insurance claims data for urinary incontinence (UI) pads has the potential to serve as an objective measure for assessing post-radical prostatectomy UI rates, but its validity for this purpose has not been established. The aim of this study is to correlate claims data with Patient Reported Outcome Measures (PROMs) for UI pad use. Patients who underwent RP in the Netherlands between September 2019 and February 2020 were included. Incontinence was defined as the daily use of ≥1 pad(s). Claims data for UI pads at 12-15 months after RP were extracted from a nationwide healthcare insurance database in the Netherlands. Participating hospitals provided PROMS data. In total, 1624 patients underwent RP. Corresponding data of 845 patients was provided by nine participating hospitals, of which 416 patients were matched with complete PROMs data. Claims data and PROMs showed 31% and 45% post-RP UI (≥1 pads). UI according to claims data compared with PROMs had a sensitivity of 62%, specificity of 96%, PPV of 92%, NPV of 75% and accuracy of 81%. The agreement between both methods was moderate (κ = 0.60). Claims data for pads moderately align with PROMs in assessing post-prostatectomy urinary incontinence and could be considered as a conservative quality indicator.
利用医疗保险理赔数据来统计尿失禁(UI)护垫的使用情况,有可能成为评估根治性前列腺切除术后尿失禁发生率的一种客观指标,但其在此方面的有效性尚未得到证实。本研究的目的是将理赔数据与患者报告的尿失禁护垫使用结局指标(PROMs)进行关联。纳入了2019年9月至2020年2月在荷兰接受根治性前列腺切除术(RP)的患者。尿失禁定义为每天使用≥1片护垫。从荷兰全国医疗保险数据库中提取RP术后12至15个月时尿失禁护垫的理赔数据。参与研究的医院提供PROMs数据。共有1624例患者接受了RP手术。9家参与研究的医院提供了845例患者的相应数据,其中416例患者的PROMs数据完整匹配。理赔数据和PROMs显示RP术后尿失禁发生率(≥1片护垫)分别为31%和45%。与PROMs相比,理赔数据诊断尿失禁的敏感性为62%,特异性为96%,阳性预测值为92%,阴性预测值为75%,准确率为81%。两种方法之间的一致性为中等(κ = 0.60)。在评估前列腺切除术后尿失禁方面,护垫的理赔数据与PROMs有适度的一致性,可被视为一个保守的质量指标。