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Assessing the validity of using administrative data to identify patients with epilepsy
Author(s) -
Tu Karen,
Wang Myra,
Jaakkimainen R. Liisa,
Butt Debra,
Ivers Noah M.,
Young Jacqueline,
Green Diane,
Jetté Nathalie
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12506
Subject(s) - confidence interval , medicine , epilepsy , population , chart , retrospective cohort study , medical record , pediatrics , psychiatry , statistics , mathematics , environmental health
Summary Objective Previous validation studies assessing the use of administrative data to identify patients with epilepsy have used targeted sampling or have used a reference standard of patients in the neurologist, hospital, or emergency room setting. Therefore, the validity of using administrative data to identify patients with epilepsy in the general population has not been previously assessed. The purpose of this study was to determine the validity of using administrative data to identify patients with epilepsy in the general population. Methods A retrospective chart abstraction study was performed using primary care physician records from 83 physicians distributed throughout O ntario and contributing data to the E lectronic M edical R ecord A dministrative data L inked D atabase ( EMRALD ) A random sample of 7,500 adult patients, from a possible 73,014 eligible, was manually chart abstracted to identify patients who had ever had epilepsy. These patients were used as a reference standard to test a variety of administrative data algorithms. Results An algorithm of three physician billing codes (separated by at least 30 days) in 2 years or one hospitalization had a sensitivity of 73.7% (95% confidence interval [ CI ] 64.8–82.5%), specificity of 99.8% (95% CI 99.6–99.9%), positive predictive value ( PPV ) of 79.5% (95% CI 71.1–88.0%), and negative predictive value ( NPV ) of 99.7% (95% CI 99.5–99.8%) for identifying patients who had ever had epilepsy. Significance The results of our study showed that administrative data can reasonably accurately identify patients who have ever had epilepsy, allowing for a “lifetime” population prevalence determination of epilepsy in O ntario and the rest of C anada with similar administrative databases. This will facilitate future studies on population level patterns and outcomes of care for patients living with epilepsy.