PDF(Pubmed)
Abstract：
BACKGROUND: Most estimates of rheumatoid arthritis (RA) prevalence, including all official figures in Australia and many other countries, are based on self-report. Self-report has been shown to overestimate RA, but the \'gold standard\' of reviewing individual medical records is costly, time-consuming and impractical for large-scale research and population monitoring. This study provides an algorithm to estimate RA cases using administrative data that can be adjusted for use in multiple contexts to provide the first approximate RA cohort in Australia that does not rely on self-report.
METHODS: Survey data on self-reported RA and medications from 25 467 respondents of the Australian Longitudinal Study on Women\'s Health (ALSWH) were linked with data from the national medication reimbursement database, hospital and emergency department (ED) episodes, and Medicare Benefits codes. RA prevalence was calculated for self-reported RA, self-reported RA medications, dispensed RA medications, and hospital/ED RA presentations. Linked data were used to exclude individuals with confounding autoimmune conditions.
RESULTS: Of 25 467 survey respondents, 1367 (5·4%) women self-reported disease. Of the 26 840 women with hospital or ED presentations, 292 (1·1%) received ICD-10 codes for RA. There were 1038 (2·8%) cases by the medication database definition, and 294 cases (1·5%) by the self-reported medication definition. After excluding individuals with other rheumatic conditions, prevalence was 3·9% for self-reported RA, 1·9% based on the medication database definition and 0·5% by self-reported medication definition. This confirms the overestimation of RA based on self-reporting.
CONCLUSIONS: We provide an algorithm for identifying individuals with RA, which could be used for population studies and monitoring RA in Australia and, with adjustments, internationally. Its balance of accuracy and practicality will be useful for health service planning using relatively easily accessible input data.
METHODS: Survey data on self-reported RA and medications from 25 467 respondents of the Australian Longitudinal Study on Women\'s Health (ALSWH) were linked with data from the national medication reimbursement database, hospital and emergency department (ED) episodes, and Medicare Benefits codes. RA prevalence was calculated for self-reported RA, self-reported RA medications, dispensed RA medications, and hospital/ED RA presentations. Linked data were used to exclude individuals with confounding autoimmune conditions.
RESULTS: Of 25 467 survey respondents, 1367 (5·4%) women self-reported disease. Of the 26 840 women with hospital or ED presentations, 292 (1·1%) received ICD-10 codes for RA. There were 1038 (2·8%) cases by the medication database definition, and 294 cases (1·5%) by the self-reported medication definition. After excluding individuals with other rheumatic conditions, prevalence was 3·9% for self-reported RA, 1·9% based on the medication database definition and 0·5% by self-reported medication definition. This confirms the overestimation of RA based on self-reporting.
CONCLUSIONS: We provide an algorithm for identifying individuals with RA, which could be used for population studies and monitoring RA in Australia and, with adjustments, internationally. Its balance of accuracy and practicality will be useful for health service planning using relatively easily accessible input data.
摘要：
背景：大多数类风湿性关节炎（RA）患病率的估计，包括澳大利亚和许多其他国家的官方数据，基于自我报告。自我报告被证明高估了RA，但是审查个人病历的“黄金标准”是昂贵的，大规模研究和人口监测耗时且不切实际。本研究提供了一种使用管理数据估计RA病例的算法，该数据可以在多种情况下进行调整，以提供澳大利亚第一个不依赖自我报告的近似RA队列。
方法：来自澳大利亚妇女健康纵向研究（ALSWH）的25467名受访者的自我报告RA和药物的调查数据与国家药物报销数据库的数据相关联，医院和急诊科（ED）发作，和医疗保险福利代码。计算自我报告RA的RA患病率，自我报告的RA药物，分配RA药物，和医院/EDRA报告。关联数据用于排除具有混杂的自身免疫性疾病的个体。
结果：在25467名调查受访者中，1367名（5·4%）女性自我报告疾病。在26840名住院或急诊就诊的妇女中，292（1·1%）收到RA的ICD-10代码。根据药物数据库定义，有1038例(2.8%)病例，根据自我报告的药物定义，有294例（1·5%）。在排除患有其他风湿病的个体后，自我报告RA的患病率为3·9%，1·9%基于药物数据库定义，0·5%基于自我报告的药物定义。这证实了基于自我报告的RA的高估。
结论：我们提供了一种识别RA个体的算法，可用于澳大利亚的人群研究和RA监测，随着调整,国际上。它的准确性和实用性的平衡将有助于使用相对容易访问的输入数据进行卫生服务计划。
方法：来自澳大利亚妇女健康纵向研究（ALSWH）的25467名受访者的自我报告RA和药物的调查数据与国家药物报销数据库的数据相关联，医院和急诊科（ED）发作，和医疗保险福利代码。计算自我报告RA的RA患病率，自我报告的RA药物，分配RA药物，和医院/EDRA报告。关联数据用于排除具有混杂的自身免疫性疾病的个体。
结果：在25467名调查受访者中，1367名（5·4%）女性自我报告疾病。在26840名住院或急诊就诊的妇女中，292（1·1%）收到RA的ICD-10代码。根据药物数据库定义，有1038例(2.8%)病例，根据自我报告的药物定义，有294例（1·5%）。在排除患有其他风湿病的个体后，自我报告RA的患病率为3·9%，1·9%基于药物数据库定义，0·5%基于自我报告的药物定义。这证实了基于自我报告的RA的高估。
结论：我们提供了一种识别RA个体的算法，可用于澳大利亚的人群研究和RA监测，随着调整,国际上。它的准确性和实用性的平衡将有助于使用相对容易访问的输入数据进行卫生服务计划。
