Klit Frederik Østergaard, Dal Jakob, Andersen Stine Linding, Nikontovic Amar, Vestergaard Peter, Karmisholt Jesper Scott
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
Clin Epidemiol. 2024 Oct 9;16:699-705. doi: 10.2147/CLEP.S484335. eCollection 2024.
Graves' disease (GD) is one of the most common causes of thyrotoxicosis. It has been proposed to identify incident GD by using the GD-specific code, E05.0, of the 10th revision of the International Classification of Disease (ICD-10) in the Danish National Patient Register (DNPR). We aimed to report the incidence of GD and to investigate the validity and completeness of E05.0 registration using Aalborg University Hospital (AaUH) as a single centre-sample.
The study included registry data from 2020 to 2022. The study population (n=2,893) comprised all people (15-99 years) in the catchment area of AaUH (n=244,872) with either positive anti-thyroid stimulating hormone receptor antibodies (TRAb), or registered with a thyroid disease related ICD-10 code E03.0-E07.9, O99.2 or O90.5 at the Department of Endocrinology, AaUH. To identify incident cases, all subjects occurring for the first time in 2020 were excluded (n=2,339). The incident subjects were categorized into a general practice (n=63) or hospital care group (n=491) and underwent GD verification by biochemical tests and thyroid imaging. Validity was evaluated by positive (PPV) and negative (NPV) predictive values and completeness of E05.0 registration was estimated to the total number of verified GD subjects in hospital care only and in overall (groups combined).
One hundred thirty-one incident GD subjects were identified corresponding to an incidence of 26.8 per 100,000/year. E05.0 had a PPV of 90% [95% CI: 81;96] and a NPV of 90% [95% CI: 85;93] to identify incident cases of GD. Completeness was estimated to be 73% [95% CI: 63;82] in hospital care and 50-60% [95% CI: 41;68] in overall.
We report on a similar incidence of GD as previous studies in Denmark. Despite a high PPV, incident cases of GD could not adequately be identified by E05.0 in DNPR due to low completeness. Researchers should rely on biochemical test results to identify incident GD.
格雷夫斯病（GD）是甲状腺毒症最常见的病因之一。有人提议在丹麦国家患者登记处（DNPR）使用国际疾病分类第10版（ICD - 10）的GD特定编码E05.0来识别新发GD。我们旨在报告GD的发病率，并以奥尔堡大学医院（AaUH）作为单中心样本，调查E05.0登记的有效性和完整性。
该研究纳入了2020年至2022年的登记数据。研究人群（n = 2893）包括AaUH服务区域内所有15至99岁的人群（n = 244872），这些人抗促甲状腺激素受体抗体（TRAb）呈阳性，或在内分泌科登记有与甲状腺疾病相关的ICD - 10编码E03.0 - E07.9、O99.2或O90.5。为识别新发病例，排除了2020年首次出现的所有受试者（n = 2339）。将新发受试者分为全科医疗组（n = 63）或医院护理组（n = 491），并通过生化检测和甲状腺成像进行GD验证。通过阳性预测值（PPV）和阴性预测值（NPV）评估有效性，仅针对医院护理组及总体（两组合并）中经核实的GD受试者总数估计E05.0登记的完整性。
共识别出131例新发GD受试者，发病率为每100000人年26.8例。E05.0识别GD新发病例的PPV为90% [95%CI：81；96]，NPV为90% [95%CI：85；93]。医院护理组的完整性估计为73% [95%CI：63；82]，总体完整性为50 - 60% [95%CI：41；68]。
我们报告的GD发病率与丹麦先前的研究相似。尽管PPV较高，但由于完整性较低，DNPR中的EOS.0无法充分识别GD新发病例。研究人员应依靠生化检测结果来识别新发GD。
