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行政数据库:小儿心肌病中的朋友还是敌人?

Administrative Databases: Friend or Foe in Paediatric Cardiomyopathy.

作者信息

Conway Jennifer, Barrett Olesya, Pidborochynski Tara, Schroeder Katie, Cunningham Chentel, Jeewa Aamir, Kaul Padma

机构信息

Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.

出版信息

CJC Pediatr Congenit Heart Dis. 2023 Oct 1;2(6Part B):490-493. doi: 10.1016/j.cjcpc.2023.09.009. eCollection 2023 Dec.

Abstract

BACKGROUND

Cardiomyopathy (CM) is a rare childhood disease associated with morbidity and mortality. Limited data exist on paediatric CM in Canada. Given the rare nature, single-centre studies are not sufficiently powered to address important questions. Therefore, administrative health data may serve as a resource for the study of childhood CM. The goal of this study was to validate the accuracy of International Classification of Diseases (ICD)-based algorithms to identify paediatric CM in health databases using a clinical registry as the gold standard.

METHODS

The clinical registry was compiled from outpatient and inpatient records at the Stollery Children's Hospital (January 1, 2013, to December 31, 2021). Patients were categorized as having CM or screened without CM. Data were linked to administrative health databases using the patient's Unique Lifetime Identifier. Algorithms based on the presence of ICD, 10th Revision, codes for CM were then evaluated, and cross-tabulations against the clinical registry were generated. Accuracy, positive predictive value, negative predictive value, sensitivity, and specificity were calculated.

RESULTS

The clinical registry had 90 patients with CM and 249 screened without CM. The algorithms ruled out CM (high negative predictive value) but had variability in the ability to diagnose CM positive predictive value. The algorithm that performed the best was based on a diagnosis of CM in a hospitalization or 2 ambulatory visits.

CONCLUSIONS

A combination of inpatient and outpatient databases can be used, with acceptable accuracy, to identify paediatric patients with CM. This finding allows for the use of the identified algorithm for the comprehensive study of paediatric CM in Canada.

摘要

背景

心肌病(CM)是一种与发病率和死亡率相关的罕见儿童疾病。加拿大关于儿童CM的数据有限。鉴于其罕见性,单中心研究的样本量不足以解决重要问题。因此,行政卫生数据可作为研究儿童CM的资源。本研究的目的是使用临床登记作为金标准,验证基于国际疾病分类(ICD)的算法在健康数据库中识别儿童CM的准确性。

方法

临床登记数据来自斯托利儿童医院的门诊和住院记录(2013年1月1日至2021年12月31日)。患者被分类为患有CM或未患有CM。使用患者的唯一终身标识符将数据与行政卫生数据库相链接。然后评估基于ICD第10版CM编码的算法,并生成与临床登记的交叉表。计算准确性、阳性预测值、阴性预测值、敏感性和特异性。

结果

临床登记中有90例CM患者和249例未患CM的筛查对象。这些算法排除CM的能力较强(阴性预测值高),但在诊断CM的能力(阳性预测值)方面存在差异。表现最佳的算法基于住院诊断或两次门诊诊断为CM。

结论

住院和门诊数据库相结合,能够以可接受的准确性识别患有CM的儿科患者。这一发现使得所确定的算法可用于加拿大儿童CM的综合研究。

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