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Accuracy and validity of using medical claims data to identify episodes of hospitalizations in patients with COPD.

https://arctichealth.org/en/permalink/ahliterature173070
Source
Pharmacoepidemiol Drug Saf. 2006 Jan;15(1):19-29
Publication Type
Article
Date
Jan-2006
Author
Amir Abbas Tahami Monfared
Jacques Lelorier
Author Affiliation
Pharmacoepidemiology and Pharmacoeconomics Research Unit, Centre de Recherche, Campus Hôtel-Dieu, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Source
Pharmacoepidemiol Drug Saf. 2006 Jan;15(1):19-29
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Algorithms
Cohort Studies
Data Collection - methods
Databases, Factual - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Length of Stay - statistics & numerical data
Male
Pulmonary Disease, Chronic Obstructive
Quebec
Reproducibility of Results
Abstract
In Quebec, MED-ECHO database can be used to estimate inhospital length of stay (LOS) and number of hospitalizations (NOH) both accurately and reliably. However, access to MED-ECHO database is time-consuming. Quebec medical claims database (RAMQ) can be used as an alternative source to estimate these measures. Considering MED-ECHO as the 'gold standard,' this study examined the validity of using RAMQ medical claims to estimate LOS and NOH.
We used a cohort of 3768 elderly patients with chronic obstructive pulmonary disease (COPD) between 1990 and 1996 and identified those with inhospital claims. Inhospital LOS was defined as the total number of days with inhospital claims. Various grace periods (1-15 days) between consecutive claims were considered for the estimation of LOS and NOH. RAMQ and MED-ECHO databases were linked using unique patient identifiers. Estimates obtained from RAMQ data were compared to those from MED-ECHO using various measures of central tendency and predictive error estimates.
Overall, 32.7% of patients were hospitalized at least once during the study period based on RAMQ claims, as compared to 32.0% in MED-ECHO ( p-value = 0.51). The best estimates [mean (p-value)] were found to be those obtained when using a 7-day grace period. RAMQ versus MED-ECHO estimates were: 12.2 versus 13.5 days (
PubMed ID
16136613 View in PubMed
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Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists.

https://arctichealth.org/en/permalink/ahliterature114676
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Publication Type
Article
Date
Oct-2013
Author
Jessica Widdifield
Sasha Bernatsky
J Michael Paterson
Karen Tu
Ryan Ng
J Carter Thorne
Janet E Pope
Claire Bombardier
Author Affiliation
University of Toronto, Toronto, Ontario, Canada.
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Algorithms
Arthritis, Rheumatoid - diagnosis - epidemiology
Data Mining - statistics & numerical data
Databases, Factual - statistics & numerical data
Drug Prescriptions - statistics & numerical data
Fees and Charges - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Male
Medical Records Systems, Computerized - statistics & numerical data
Middle Aged
Ontario - epidemiology
Reproducibility of Results
Retrospective Studies
Rheumatology - statistics & numerical data
Single-Payer System - statistics & numerical data
Abstract
Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada.
We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data.
One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with =1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date.
We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance.
PubMed ID
23592598 View in PubMed
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[A databank on Russian families with hereditary neuromuscular diseases].

https://arctichealth.org/en/permalink/ahliterature201190
Source
Zh Nevrol Psikhiatr Im S S Korsakova. 1999;99(7):52-4
Publication Type
Article
Date
1999
Author
I N Lunga
S S Shishkin
N I Shakhovskaia
N L Gerasimova
D I Zelinskaia
A A Khodunova
V A Shakhovskii
M A Tarksh
I N Krakhmaleva
Source
Zh Nevrol Psikhiatr Im S S Korsakova. 1999;99(7):52-4
Date
1999
Language
Russian
Publication Type
Article
Keywords
Commonwealth of Independent States - epidemiology
Databases, Factual - statistics & numerical data
Female
Humans
Male
Neuromuscular Diseases - diagnosis - epidemiology - genetics
Postal Service
Prevalence
Questionnaires
Random Allocation
Russia - epidemiology
Abstract
The information about 5 thousands Russian families with hereditary neuromuscular disorders (HNMD) was collected by means of both different genetic epidemiological methods and authors' own observations. On the basis of this material a computer database MYODYS in Excel 5.0 format was created, which included information about 30 different signs concerning 1920 families from 70 regions of Russia. The study of the data, included in MYODYS, revealed several problems in practical diagnosis of HNMD in Russia. It is necessary to resolve these important problems for correct genetic consulting and treatment. MYODYS database may serve as a basis for elaboration of a special complex programme for long-term support of the families with NNMD in Russia.
PubMed ID
10441854 View in PubMed
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Adherence to Canadian best practice recommendations for stroke care: assessment and management of poststroke depression in an Ontario rehabilitation facility.

https://arctichealth.org/en/permalink/ahliterature125961
Source
Top Stroke Rehabil. 2012 Mar-Apr;19(2):132-40
Publication Type
Article
Author
Katherine Salter
J Andrew McClure
Hannah Mahon
Norine Foley
Robert Teasell
Author Affiliation
Lawson Health Research Institute, London, Ontario, Canada.
Source
Top Stroke Rehabil. 2012 Mar-Apr;19(2):132-40
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Databases, Factual - statistics & numerical data
Depressive Disorder - psychology - rehabilitation
Female
Guideline Adherence - standards
Health Personnel - standards
Humans
Male
Medical Audit
Middle Aged
Ontario
Practice Guidelines as Topic
Process Assessment (Health Care)
Retrospective Studies
Stroke - psychology - rehabilitation
Abstract
Although Canadian best practice recommendations regarding assessment and management of poststroke depression (PSD) have been established, the degree to which these evidence-based guidelines have been translated into practice is not known. The objectives of the present study are to compare current and recommended best practice and examine possible reasons for identified care gaps.
Practice audit by chart review was performed to identify recorded screening, assessment, and treatment for PSD in patients discharged from a specialized inpatient rehabilitation program over a 6-month period. A questionnaire was administered to all clinical staff addressing current screening practices as well as opinions regarding the importance and feasibility of identification and treatment of PSD.
Of 123 patients, 40 (32.5%) had been prescribed antidepressants at discharge. However, evidence of screening was found for 4.9% of patients; another 9.8% were referred for psychological consult. Treatment was associated with previous antidepressant use or history of depression, but not screening or assessment. Of the survey respondents, 56.2% were not aware of best practice recommendations. However, most felt screening and assessment to be important and treatment was regarded as both simple and effective.
Despite potential benefit associated with identification and treatment of PSD and the availability of evidence-based best practice recommendations, PSD may remain unrecognized and undertreated. Given the juxtaposition of perceived importance with the lack of documented best practice, education regarding standardized screening and the development of consistent clinical protocols including roles and responsibilities in the identification, diagnosis, and treatment of PSD are underway.
PubMed ID
22436361 View in PubMed
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Adherence to guidelines on the management of dystocia and cesarean section rates.

https://arctichealth.org/en/permalink/ahliterature163725
Source
Am J Perinatol. 2007 May;24(5):271-5
Publication Type
Article
Date
May-2007
Author
Lawrence W Oppenheimer
Paul Holmes
Qiuying Yang
Tubao Yang
Mark Walker
Shi Wu Wen
Author Affiliation
Division of Maternal-Fetal Medicine, Ottawa Hospital, Ottawa, Ontario, Canada.
Source
Am J Perinatol. 2007 May;24(5):271-5
Date
May-2007
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cesarean Section - standards - utilization
Databases, Factual - statistics & numerical data
Dystocia - prevention & control
Female
Guideline Adherence - statistics & numerical data
Humans
Obstetrics
Practice Guidelines as Topic
Pregnancy
Retrospective Studies
Societies, Medical
Abstract
The purpose of this study was to investigate to what extent the Society of Obstetricians and Gynecologists of Canada (SOGC) guidelines on dystocia are being followed, and whether adherence to the guidelines is related to cesarean section rates. Data were extracted from a maternity database for nulliparous women with singleton, cephalic pregnancies at 37 or more completed weeks of gestation for a 4-year period. Patients delivered by elective cesarean section were excluded. Data were examined to determine whether those who had a cesarean section for dystocia in the first stage of labor fulfilled SOGC guidelines. In addition, the obstetricians were divided into two groups (high or low) according to their cesarean section rate for dystocia to determine whether a higher section rate was associated with an increased guideline violation rate. There were 239 nulliparous women who had a cesarean section for dystocia in the first stage of labor. The guidelines were followed in 47.7% of spontaneous labors and 77.5% of inductions. The mean section rate for dystocia in the first stage of labor was 10.8% in the high group and 6.6% in the low group, and the incidence of guideline violations in these groups was 48.0% and 39.6%, respectively ( P = 0.07). The study had a power of 0.88 to detect a 40% difference in guideline violation rates between the two groups. We conclude that many women have cesarean section for dystocia performed without fulfilling SOGC guidelines.
PubMed ID
17484079 View in PubMed
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Adoption of celecoxib and rofecoxib: a nationwide database study.

https://arctichealth.org/en/permalink/ahliterature175412
Source
J Clin Pharm Ther. 2005 Apr;30(2):145-52
Publication Type
Article
Date
Apr-2005
Author
A. Helin-Salmivaara
R. Huupponen
A. Virtanen
T. Klaukka
Author Affiliation
Centre for Pharmacotherapy Development, Helsinki, Finland. arja.helin-salmivaara@rohto.fi
Source
J Clin Pharm Ther. 2005 Apr;30(2):145-52
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Age Factors
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Child
Databases, Factual - statistics & numerical data - trends
Drug Utilization Review - methods
Finland - epidemiology
Humans
Insurance, Pharmaceutical Services - trends - utilization
Lactones - therapeutic use
Medicine - statistics & numerical data
Physician's Practice Patterns - statistics & numerical data - trends
Product Surveillance, Postmarketing - economics - methods
Pyrazoles - therapeutic use
Retrospective Studies
Sex Factors
Specialization
Sulfonamides - therapeutic use
Sulfones - therapeutic use
Time Factors
Abstract
Cyclooxygenase 2-selective non-steroidal anti-inflammatory drugs (NSAIDs, coxibs) are recommended primarily for patients at high risk of gastrointestinal bleeding, most of them being elderly. Our objective was to describe and analyse patient- and physician-related factors affecting the adoption of celecoxib and rofecoxib 2 years after their launch in Finland.
Retrospective analysis of the nationwide Prescription Register. Physicians who had issued at least 200 reimbursed prescriptions in 2002 (n = 12 033, 80% of working-age Finnish physicians) were involved in the analysis.
Excluding patients with rheumatoid arthritis (RA), almost one-fifth (18%) of NSAIDs prescriptions were for coxibs. In patients with RA the share was 25%. The share of coxib prescriptions of all NSAIDs increased with age of the patient. Over one half (58%) of coxib prescriptions were issued for patients under 65 years of age. Specialists in physical and rehabilitation medicine were the fastest adopters of coxibs: one-third of their NSAID prescriptions in 2002 were for coxibs. Primary care physicians were the most conservative both in adopting and favouring coxibs.
Coxibs have gained the status of standard prescription NSAIDs within a few years. Their use should be restricted to patients who could benefit most from the use. Routine prescribing of expensive new drugs increases the drug bill without additional health gain.
PubMed ID
15811167 View in PubMed
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Advancing paternal age and risk of autism: new evidence from a population-based study and a meta-analysis of epidemiological studies.

https://arctichealth.org/en/permalink/ahliterature138993
Source
Mol Psychiatry. 2011 Dec;16(12):1203-12
Publication Type
Article
Date
Dec-2011
Author
C M Hultman
S. Sandin
S Z Levine
P. Lichtenstein
A. Reichenberg
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Source
Mol Psychiatry. 2011 Dec;16(12):1203-12
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Autistic Disorder - epidemiology - genetics - psychology
Cohort Studies
Databases, Factual - statistics & numerical data
Family Health - statistics & numerical data
Female
Humans
Male
Maternal Age
Middle Aged
Paternal Age
Risk factors
Siblings - psychology
Sweden - epidemiology
Abstract
Advanced paternal age has been suggested as a risk factor for autism, but empirical evidence is mixed. This study examines whether the association between paternal age and autism in the offspring (1) persists controlling for documented autism risk factors, including family psychiatric history, perinatal conditions, infant characteristics and demographic variables; (2) may be explained by familial traits associated with the autism phenotype, or confounding by parity; and (3) is consistent across epidemiological studies. Multiple study methods were adopted. First, a Swedish 10-year birth cohort (N=1?075?588) was established. Linkage to the National Patient Register ascertained all autism cases (N=883). Second, 660 families identified within the birth cohort had siblings discordant for autism. Finally, meta-analysis included population-based epidemiological studies. In the birth cohort, autism risk increased monotonically with increasing paternal age. Offspring of men aged =50 years were 2.2 times (95% confidence interval: 1.26-3.88: P=0.006) more likely to have autism than offspring of men aged =29 years, after controlling for maternal age and documented risk factors for autism. Within-family analysis of discordant siblings showed that affected siblings had older paternal age, adjusting for maternal age and parity (P
PubMed ID
21116277 View in PubMed
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Age-related differences in the side effect profile of citalopram.

https://arctichealth.org/en/permalink/ahliterature53561
Source
Prog Neuropsychopharmacol Biol Psychiatry. 2003 May;27(3):545-8
Publication Type
Article
Date
May-2003
Author
Yoram Barak
Marnina Swartz
Daniel Levy
Ronit Weizman
Author Affiliation
Psychogeriatric Department, Abarbanel Mental Health Center, 15 KKL Street, Bat-Yam 59100, Israel. mdybarak@netvision.net.il
Source
Prog Neuropsychopharmacol Biol Psychiatry. 2003 May;27(3):545-8
Date
May-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Bradycardia - chemically induced
Chi-Square Distribution
Citalopram - adverse effects
Comparative Study
Confidence Intervals
Databases, Factual - statistics & numerical data
Headache - chemically induced
Humans
Middle Aged
Sweating - drug effects
Abstract
The authors evaluated the autonomic and cardiovascular side effects of citalopram with particular emphasis on their relation to the age of treated patients. The data that formed the basis for the U.S. Food and Drug Administration approval of citalopram were provided by Lundbeck (Copenhagen, Denmark). This database included placebo-controlled short- and long-term studies in major depressed patients. The list of side effects comprised all "heart rate and rhythm disorders" as well as "autonomic nervous system disorders" that had been reported by at least 5% more than that reported for the placebo group of subjects. The database encompassed 1344 subjects treated with citalopram (20-60 mg/day) for a period of no less than 6 weeks. Statistically significant age-related distribution was found for five side effects: bradycardia, nausea, diarrhea, sweating and headache. Bradycardia was more prevalent in elderly (>65 years) patients as compared to the younger population (2.4% vs. 0.2%, P
PubMed ID
12691792 View in PubMed
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Aging, spinal cord injury, and quality of life: structural relationships.

https://arctichealth.org/en/permalink/ahliterature184088
Source
Arch Phys Med Rehabil. 2003 Aug;84(8):1137-44
Publication Type
Article
Date
Aug-2003
Author
Mary Ann McColl
Robert Arnold
Susan Charlifue
Clive Glass
Gordana Savic
Hans Frankel
Author Affiliation
Queen's University, Kingston, ON, Canada. mccollm@post.queensu.ca
Source
Arch Phys Med Rehabil. 2003 Aug;84(8):1137-44
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Aging
Canada - epidemiology
Colorado - epidemiology
Cross-Sectional Studies
Databases, Factual - statistics & numerical data
Disability Evaluation
Disabled Persons - rehabilitation - statistics & numerical data
England - epidemiology
Female
Humans
Male
Middle Aged
Quality of Life
Questionnaires
Spinal Cord Injuries - epidemiology - rehabilitation
Abstract
To quantify relationships among 3 sets of factors: demographic factors, health and disability factors, and quality of life (QOL).
Part of a program of longitudinal research on aging and spinal cord injury (SCI) involving 3 populations: American, British, and Canadian. The present analysis uses data from the 1999 interval.
The Canadian sample was derived from the member database of the Ontario and Manitoba divisions of the Canadian Paraplegic Association. The British sample was recruited from a national and a regional SCI center in England. The American sample was recruited through a hospital in Colorado.
A sample of 352 participants was assembled from 4 large, well-established databases. The sample included individuals who had incurred an SCI at least 20 years earlier, were admitted to rehabilitation within 1 year of injury, and were between the ages of 15 and 55 at the time of injury.
Not applicable.
A combination of self-completed questionnaires and interviews. Data included demographics, injury-related variables, health and disability-related factors, QOL, and perceptions about aging.
Using linear structural relationships modeling, we found that QOL was affected both directly and indirectly by age, health and disability problems, and perceptions of aging. Two surprising findings were as follows: those who experienced fewer disability-related problems were more likely to report a qualitative disadvantage in aging, and the younger members of the sample were more likely to report fatigue.
Fatigue is a concern because of the relationship of fatigue with perceived temporal disadvantage in aging, health problems, and disability problems. This finding highlights the need for clinical vigilance among those just beginning to experience the effects of aging.
PubMed ID
12917851 View in PubMed
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Algorithms to estimate the beginning of pregnancy in administrative databases.

https://arctichealth.org/en/permalink/ahliterature124762
Source
Pharmacoepidemiol Drug Saf. 2013 Jan;22(1):16-24
Publication Type
Article
Date
Jan-2013
Author
Andrea V Margulis
Soko Setoguchi
Murray A Mittleman
Robert J Glynn
Colin R Dormuth
Sonia Hernández-Díaz
Author Affiliation
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. andreamargulis@post.harvard.edu
Source
Pharmacoepidemiol Drug Saf. 2013 Jan;22(1):16-24
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Algorithms
British Columbia
Databases, Factual - statistics & numerical data
Female
Gestational Age
Humans
Infant, Newborn
Pregnancy
Premature Birth - epidemiology
Sensitivity and specificity
Abstract
The role of administrative databases for research on drug safety during pregnancy can be limited by their inaccurate assessment of the timing of exposure, as the gestational age at birth is typically unavailable. Therefore, we sought to develop and validate algorithms to estimate the gestational age at birth using information available in these databases.
Using a population-based cohort of 286,432 mother-child pairs in British Columbia (1998-2007), we validated an ICD-9/10-based preterm-status indicator and developed algorithms to estimate the gestational age at birth on the basis of this indicator, maternal age, singleton/multiple status, and claims for routine prenatal care tests. We assessed the accuracy of the algorithm-based estimates relative to the gold standard of the clinical gestational age at birth recorded in the delivery discharge record.
The preterm-status indicator had specificity and sensitivity of 98% and 91%, respectively. Estimates from an algorithm that assigned 35?weeks of gestational age at birth to deliveries with the preterm-status indicator and 39?weeks to those without them were within 2?weeks of the clinical gestational age at birth in 75% of preterm and 99% of term deliveries.
Subtracting 35?weeks (245?days) from the date of birth in deliveries with codes for preterm birth and 39?weeks (273?days) in those without them provided the optimal estimate of the beginning of pregnancy among the algorithms studied.
Notes
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Cites: N Engl J Med. 2006 Jun 8;354(23):2443-5116760444
Cites: Arch Gen Psychiatry. 2006 Aug;63(8):898-90616894066
Cites: Pharmacoepidemiol Drug Saf. 2006 Aug;15(8):546-5416586470
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Cites: J Obstet Gynaecol Can. 2007 Feb;29(2):146-7917346485
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Cites: Am J Obstet Gynecol. 2007 Jun;196(6):544.e1-517547888
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Cites: Obstet Gynecol. 2010 Jun;115(6):1201-820502291
Cites: Arch Neurol. 2005 Sep;62(9):1362-516157743
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Cites: Am J Epidemiol. 2001 Jul 15;154(2):180-711447053
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Cites: Acta Obstet Gynecol Scand. 1990;69(3):197-2072220340
PubMed ID
22550030 View in PubMed
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190 records – page 1 of 19.