Accuracy and Sensitivity of Parkinsonian Disorder Diagnoses in Two Swedish National Health Registers

Feldman, Adina L.; Johansson, Anna L.V.; Gatz, Margaret; Flensburg, Måns; Petzinger, Giselle M.; Widner, Håkan; Lew, Mark F.; Pedersen, Nancy L.; Wirdefeldt, Karin

doi:10.1159/000336356

Cited by 60 publications

(124 citation statements)

References 39 publications

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“…Second, we obtained PD diagnoses from the National Patient Register in which inpatient PD diagnoses have been validated against clinical diagnoses showing good accuracy; however, misclassification between PD and other parkinsonian disorders occurs. [23] We have no reason to believe that the magnitude of this misclassification differs by SES, therefore resulting in a bias toward the null. Another potential limitation in our study is surveillance bias; [36] participants in higher socioeconomic groups may be more health-conscious, more likely to seek care, resulting in earlier detection of PD.…”

Section: Discussionmentioning

confidence: 99%

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Socioeconomic status in relation to Parkinson's disease risk and mortality

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…Our previous validation of hospital discharge diagnosis of PD against clinical diagnosis showed a positive predictive value of 70.8% and a sensitivity of 72.7%. [23] …”

Section: Methodsmentioning

confidence: 99%

Socioeconomic status in relation to Parkinson's disease risk and mortality

et al. 2016

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“…The accuracy of the PD diagnoses in the Swedish National Inpatient Register has been reported to be 70.8% [9]. The cases were identified by the main and up to seven contributory diagnoses.…”

Section: Methodsmentioning

confidence: 99%

Alcohol use disorders and risk of Parkinson’s disease: findings from a Swedish national cohort study 1972–2008

et al. 2013

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BackgroundAlcohol has been suggested to be either protective of, or not associated with Parkinson’s disease (PD). However, experimental animal studies indicate that chronic heavy alcohol consumption may have dopamine neurotoxic effects relevant for PD. We studied the association between diagnosed alcohol use disorders and PD.MethodsAll individuals in Sweden admitted with a diagnosis of an alcohol use disorder or appendicitis (reference group) between January 1, 1972 and December 31, 2008 were identified through the Swedish National Inpatient Register, and followed for up to 37 years for a diagnosis of PD. We estimated hazard ratios (HR) with 95% confidence intervals (CI) and adjusted for age and sex.ResultsWe found 1,741 (0.3%) cases of PD in the cohort of 602,930 individuals, 1,083 (0.4%) among those admitted with an alcohol use disorder and 658 (0.2%) of the individuals admitted with appendicitis. The mean follow-up time was 13.6 and 17.1 years, respectively. The HR for PD associated with an alcohol use disorder was 1.38 (CI 1.25-1.53) adjusted for age and sex. When the risk was estimated in age groups for first hospital admission with PD the highest risk was observed in the lowest age group, ≤44, HR 2.39 (0.96-5.93), adjusted for age at exposure and sex.ConclusionsA history of an alcohol use disorder conferred an increased risk of admission with a diagnosis of Parkinson’s disease in both women and men. In particular, the risk seemed higher at lower ages of first admission with Parkinson’s disease.

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“…On the other hand, if occupational stress or other aspects related to occupation are associated with propensity to seek medical care, this could have differentially biased our results. To increase the accuracy of PD diagnoses, we only included hospital admissions and outpatient visits with PD as the main diagnosis, as suggested by a previous validation study …”

Section: Discussionmentioning

confidence: 99%

“…Date of ascertainment was defined as the first date of any PD diagnosis in the NPR or date of death in the CDR for those cases only identified at death. A previous validation study concluded that the NPR and CDR are valid data sources in epidemiological studies of PD with generally good accuracy and sensitivity …”

Section: Methodsmentioning

confidence: 99%

Occupational stress and risk for Parkinson's disease: A nationwide cohort study

et al. 2018

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Background: Stress has been suggested as a contributing factor in the etiology of Parkinson's Disease (PD), but epidemiological evidence is sparse. Objective: The objective of this study was to explore the association between occupational stress according to the job demands‐control model and the risk for PD. Methods: We conducted a population‐based cohort study with 2,544,748 Swedes born 1920 to 1950 who had an occupation reported in the population and housing censuses in 1980 or, if missing, in 1970. Job demands and control were measured using a job‐exposure matrix. Incident PD cases were identified using Swedish national health registers from 1987 to 2010. Data were analyzed with Cox regression with age as the underlying time scale, adjusting for sex, education, and chronic obstructive pulmonary disease as a proxy for smoking. Results: During a mean follow‐up time of 21.3 years, 21,544 incident PD cases were identified. High demands were associated with increased PD risk among men, most evident in men with high education. High control was associated with increased PD risk among the low educated. This association was more pronounced in women. High‐strain jobs (high demands and low control) was only associated with increased PDrisk among men with high education, whereas active jobs (high demands and high control) were associated with increased PD risk among men with low education. Interpretation: High job demands appear to increase PD risk in men, especially in men with high education, whereas high job control increases PD risk among low educated, more strongly in women. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Accuracy and Sensitivity of Parkinsonian Disorder Diagnoses in Two Swedish National Health Registers

Cited by 60 publications

References 39 publications

Socioeconomic status in relation to Parkinson's disease risk and mortality

Socioeconomic status in relation to Parkinson's disease risk and mortality

Alcohol use disorders and risk of Parkinson’s disease: findings from a Swedish national cohort study 1972–2008

Occupational stress and risk for Parkinson's disease: A nationwide cohort study

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