Validating a case definition for adult asthma in primary care electronic medical records.

Autor: Cave AJ; Department of Family Medicine, University of Alberta, Edmonton, AB, Canada. acave@ualberta.ca., Soos B; Department of Family Medicine, University of Calgary, Calgary, AB, Canada.; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada., Gillies C; Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.; Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada., Drummond N; Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.; Department of Family Medicine, University of Calgary, Calgary, AB, Canada.; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.; School of Public Health, University of Alberta, Edmonton, AB, Canada., Pham ANQ; Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.; School of Public Health, University of Alberta, Edmonton, AB, Canada., Williamson T; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Jazyk: angličtina
Zdroj: NPJ primary care respiratory medicine [NPJ Prim Care Respir Med] 2020 Jun 05; Vol. 30 (1), pp. 24. Date of Electronic Publication: 2020 Jun 05.
DOI: 10.1038/s41533-020-0181-3
Abstrakt: Although asthma is one of the most common chronic conditions affecting Canadians, its epidemiologic characteristics and burden in primary care contexts are poorly understood. The aim of this study was to develop and validate a case definition to identify adults with asthma who consult family physicians and to estimate the prevalence of asthma in that setting in Canada. This validation study utilized a database of electronic medical records (EMRs) from the Southern Alberta Primary Care Research Network, a node of the Canadian Primary Care Sentinel Surveillance Network (SAPCReN-CPCSSN). The population included patients over age 17y of any gender and health status who had visited an SAPCReN-CPCSSN primary care provider during the period December 1, 2014-December 31, 2016. The validation of the case definition involved comparing a case-finding algorithm to caseness determined by an expert physician review of the records of 1000 patient in the CPCSSN database. The case definition, which included the ICD-9 code 493 and asthma-related text words, had 83.33% sensitivity (95% CI: 63.61-93.88%), 99.28% specificity (95% CI: 98.51-99.67%), a positive predictive value of 74.07% (95% CI: 55.03-87.14%), and a negative predictive value of 99.59% (95% CI: 98.93-99.86%). The prevalence of adult asthma in CPCSSN primary care practices in southern Alberta was 4.20% (95% CI: 4.09-4.31). The strong validation metrics suggest that this case definition is valid for both clinical and research purposes. The validated case definition may be used to improve patient care and improve understanding of the prevalence and burden of asthma in primary care in Canada.
Databáze: MEDLINE