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Identification of incident pancreatic cancer in Ontario administrative health data: A validation study
Author(s) -
Wu Jennifer W.,
Azoulay Laurent,
Huang Anjie,
Paterson Michael,
Wu Fangyun,
Secrest Matthew H.,
Filion Kristian B.
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4641
Subject(s) - medicine , pancreatic cancer , medical diagnosis , confidence interval , diagnosis code , cancer registry , cohort , emergency medicine , cancer , predictive value , radiology , population , environmental health
Abstract Purpose To validate three approaches for identifying incident cases of pancreatic cancer in Ontario administrative claims data. Methods We created a cohort using Ontario (Canada) administrative health data from 2002 to 2012 and identified cases of pancreatic cancer with three approaches, using the Ontario Cancer Registry (OCR) as the reference standard. In the any diagnosis approach, cases were defined by primary or secondary diagnostic codes for pancreatic cancer in outpatient or inpatient records. In the any inpatient diagnosis approach, cases were defined using only diagnoses in hospital discharge abstracts. In the algorithm approach, cases were identified by an algorithm that combined the first two approaches. Comparing each approach to the OCR, we calculated the expected value and 95% confidence interval (CI) of the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). We also compared the event dates using each approach with those recorded in the OCR. Results Among a total of 12 060 837 patients in Ontario administrative health data sources, 13 999 incident pancreatic cancer cases were identified in the OCR. Sensitivity ranged from 72.5% ( algorithm ) to 97.5% ( any diagnosis ), and PPV ranged from 38.4% ( any diagnosis ) to 78.9% ( any inpatient diagnosis ). Specificity and NPV were ~100% for all approaches. The median absolute difference in cancer event date ranged 0 to 15 days. The any inpatient diagnosis method had the highest PPV (78.9%; 95% CI: 78.2‐79.5%) and moderate sensitivity (86.6%; 95% CI: 86.0‐87.2%). Conclusion Inpatient diagnoses of pancreatic cancer in Ontario administrative heath data are suitable for pancreatic cancer case identification.