Development and validation of an administrative data algorithm to estimate the disease burden and epidemiology of multiple sclerosis in Ontario, Canada

Widdifield, Jessica; Ivers, Noah; Young, Jacqueline; Green, Diane; Jaakkimainen, Liisa; Butt, Debra A.; O’Connor, Paul; Hollands, Simon; Tu, Karen

doi:10.1177/1352458514556303

Cited by 82 publications

(89 citation statements)

References 24 publications

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“…The model projected a conservative increase in the prevalence of MS of 6.5% per decade. In all Canadian provinces where it has been evaluated over time, the prevalence of MS has increased, [21][22][23][24]36 consistent with our findings. However, the degree of change has varied, from 13.5% per decade in Manitoba 22 to 55% per decade in Ontario.…”

Section: Strengths and Limitationssupporting

confidence: 81%

“…However, the degree of change has varied, from 13.5% per decade in Manitoba 22 to 55% per decade in Ontario. 24 That variance could be a reflection of the application of diagnostic or reporting criteria, or, our findings may underestimate the future impact of MS.…”

Section: Strengths and Limitationsmentioning

confidence: 96%

“…Prevalence estimates across Canada are variable, with estimates per 100 000 population based on administrative data ranging from 207.3 in Ontario in 2010 24 to 266.9 in Nova Scotia in 2010, 21 and as high as 357.6 in the contiguous province of Alberta in 2004. 35 Despite this variance, the estimated age-and sex-specific prevalence rates are quite similar to estimates based on the 2010-11 36 Canadian Community Health Survey (CCHS; see Figure 2), recognizing that the CCHS did not capture those living in long-term care, who represent 5.8% to 9.2% of the MS population aged 65 years and older.…”

Section: Pohem-neurological Validationmentioning

confidence: 99%

“…Incidence and prevalence rates estimated from the British Columbia (BC) population were of comparable magnitude to those of the published studies from Canadian settings and provincial/territorial pilots. [22][23][24][25] Using these age-and sex-specific incidence rates, actors were classified as being diagnosed with MS, based on each actor's risk of developing MS at the beginning of each new calendar year. Incident MS cases accumulated over time to generate prevalent cases of MS.…”

Section: Ms Status: Incidencementioning

confidence: 99%

“…First, we applied empirical estimates of sex-and age-specific MS incidence rates to the model's synthetic Canadian population for each year, both historical and projected. We estimated incidence rates using a validated case definition algorithm † that had a sensitivity of 84.0% for adults aged 20 years and older, 23 and specificity of 99.9% 24 applied to a cohort from the province of Ontario. Individuals under age 20 years were excluded, given the low incidence of acquired demyelinating syndromes (ADS) leading to MS in Canadian children and adolescents.…”

Section: Ms Status: Incidencementioning

confidence: 99%

See 4 more Smart Citations

Multiple sclerosis in Canada 2011 to 2031: results of a microsimulation modelling study of epidemiological and economic impacts

Amankwah

Marrie

Bancej

et al. 2017

Health Promot Chronic Dis Prev Can

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Section: Strengths and Limitationssupporting

confidence: 81%

Section: Strengths and Limitationsmentioning

confidence: 96%

Section: Pohem-neurological Validationmentioning

confidence: 99%

Section: Ms Status: Incidencementioning

confidence: 99%

Section: Ms Status: Incidencementioning

confidence: 99%

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Multiple sclerosis in Canada 2011 to 2031: results of a microsimulation modelling study of epidemiological and economic impacts

Amankwah

Marrie

Bancej

et al. 2017

Health Promot Chronic Dis Prev Can

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Venous Thromboembolism After COVID-19 Infection Among People With and Without Immune-Mediated Inflammatory Diseases

Khan,

Kuenzig,

Tang

et al. 2023

JAMA Netw Open

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ImportanceImmune-mediated inflammatory diseases (IMIDs) and COVID-19 are independently associated with venous thromboembolisms (VTEs).ObjectiveTo determine if individuals with IMIDs are at higher risk of VTE following COVID-19 infection compared with individuals without IMIDs.Design, Setting, and ParticipantsPopulation-based matched cohort study using multiple deterministically linked health administrative databases from Ontario, Canada, and including patients testing positive for COVID-19 between January 1, 2020, and December 30, 2021, and followed up until March 31, 2022. Individuals with IMIDs (n = 28 440) who tested positive for COVID-19 were matched with up to 5 individuals without an IMID (n = 126 437) who tested positive for COVID-19. Matching was based on year of birth, sex, neighborhood income, and rural/urban residence. Data analysis was performed from August 6, 2022, to August 21, 2023.ExposureDiagnosis of an IMID, identified using algorithms based on diagnostic codes, procedures, and specialist visits.Main Outcome and MeasureThe main outcome was estimated age- and sex-standardized incidence of VTE. Proportional cause-specific hazard models compared the risk of VTE in people with and without IMIDs. Death was a competing risk. Models adjusted for history of VTE, 2 or more doses of a COVID-19 vaccine 14 or more days prior to COVID-19 diagnosis, and the Charlson Comorbidity Index. Routinely collected health data were used, so the hypothesis tested was formulated after data collection but prior to being granted access to data.ResultsThe study included 28 440 individuals (16 741 [58.9%] female; 11 699 [41.1%] male) with an IMID diagnosed prior to first COVID-19 diagnosis, with a mean (SD) age of 52.1 (18.8) years at COVID-19 diagnosis. These individuals were matched to 126 437 controls without IMIDs. The incidence of VTE within 6 months of COVID-19 diagnosis among 28 440 individuals with an IMID was 2.64 (95% CI, 2.23-3.10) per 100 000 person-days compared with 2.18 (95% CI, 1.99-2.38) per 100 000 person-days among 126 437 matched individuals without IMIDs. The VTE risk was not statistically significantly different among those with vs without IMIDs (adjusted hazard ratio, 1.12; 95% CI, 0.95-1.32).Conclusions and RelevanceIn this retrospective population-based cohort study of individuals with IMIDs following COVID-19, individuals with IMIDs did not have a higher risk of VTE compared with individuals without an IMID. These data provide reassurance to clinicians caring for individuals with IMIDs and COVID-19.

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Understanding COVID‐19 Risk in Patients With Immune‐Mediated Inflammatory Diseases: A Population‐Based Analysis of SARS–CoV‐2 Testing

Eder

Croxford

Drucker

et al. 2022

Arthritis Care & Research

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Objective To investigate the incidence of and factors associated with SARS‐CoV‐2 testing and infection in immune mediated inflammatory diseases (IMIDs) versus matched non‐IMIDs comparators from the general population. Methods We conducted a population‐based, matched cohort study among adult residents from Ontario, Canada, from January to December 2020. We created cohorts for the following IMIDs: rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, ankylosing spondylitis, systemic autoimmune rheumatic diseases, multiple sclerosis (MS), iritis, inflammatory bowel disease (IBD), polymyalgia rheumatica and vasculitis. Each patient was matched with five patients without IMIDs based on socio‐demographic factors. We estimated the incidence of SARS‐CoV‐2 testing and infection in IMIDs and non‐IMIDs patients. Multivariable logistic regressions assessed odds of SARS‐CoV‐2 infection. Results We studied 493,499 patients with IMIDs and 2,466,946 patients without IMIDs. Patients with IMIDs were more likely to have at least one SARS‐CoV‐2 test, versus patients without IMIDs (27.4% vs. 22.7%), but the proportion testing positive for SARS‐CoV‐2 was identical (0.9% in both groups). Overall, IMIDs patients had 20% higher odds of being tested for SARS‐CoV‐2 (odds ratio (OR) 1.20, 95% CI 1.19, 1.21). The odds of SARS‐CoV‐2 infection varied across IMIDs groups but was not significantly elevated for most IMID groups compared with non‐IMIDs. The odds of SARS‐CoV‐2 infection was lower in IBD and MS and marginally higher in RA and iritis. Conclusions Patients across all IMIDs were more likely to be tested for SARS‐CoV‐2 versus those without IMIDs. The risk of SARS‐CoV‐2 infection varied across disease sub‐groups.

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Development and validation of an administrative data algorithm to estimate the disease burden and epidemiology of multiple sclerosis in Ontario, Canada

Abstract: MS patients can be accurately identified from administrative data. Our findings illustrated a rising prevalence of MS over time. MS incidence rates also appear to be rising since 2009.

Cited by 82 publications

References 24 publications

Multiple sclerosis in Canada 2011 to 2031: results of a microsimulation modelling study of epidemiological and economic impacts

Multiple sclerosis in Canada 2011 to 2031: results of a microsimulation modelling study of epidemiological and economic impacts

Venous Thromboembolism After COVID-19 Infection Among People With and Without Immune-Mediated Inflammatory Diseases

Understanding COVID‐19 Risk in Patients With Immune‐Mediated Inflammatory Diseases: A Population‐Based Analysis of SARS–CoV‐2 Testing

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