Validation of a case definition for osteoporosis disease surveillance

Abstract

A relatively simple case definition for osteoporosis surveillance based upon administrative health data can achieve an acceptable level of sensitivity, specificity, and accuracy. Performance is enhanced when the case definition includes osteoporosis medication use in the formulation.

Use of administrative data for national surveillance of osteoporosis and related fractures in Canada: results from a feasibility study

“…Results are consistent with previous studies involving the validation of algorithms for osteoporosis and fracture surveillance using administrative data [5][6][7][8]. While results are slightly lower than self-reported estimates of diagnosed osteoporosis from the Canadian Community Health Survey (CCHS) which showed 11.9 % of Canadians 50 years and older reported they were diagnosed with osteoporosis by a health professional in 2009 [21].…”

“…Table 1 lists the algorithms adopted by the CCDSS Osteoporosis Working Group for osteoporosis and osteoporosis-related fractures (and their corresponding ICD-9-CM and ICD-10-CA codes) for future testing. Working group members' decision regarding which algorithms to adopt was based on results from this feasibility study as well as results from the aforementioned validation studies [5][6][7][8], published osteoporosis prevalence and fracture incidence estimates [15][16][17], and the availability/completeness of the administrative databases required.…”

“…Osteoporosis and fracture algorithms using diagnostic codes found in administrative databases have been constructed and validated for surveillance purposes [5][6][7][8][9][10][11]. Leslie et al validated algorithms to identify cases of diagnosed osteoporosis using administrative data and demonstrated that a relatively simple algorithm which combined hospitalizations and physician visits could achieve an acceptable level of sensitivity, specificity, and accuracy [5].…”

“…Leslie et al validated algorithms to identify cases of diagnosed osteoporosis using administrative data and demonstrated that a relatively simple algorithm which combined hospitalizations and physician visits could achieve an acceptable level of sensitivity, specificity, and accuracy [5]. In addition, Lix et al validated algorithms using administrative data to estimate fracture incidence of the hip, wrist, humerus, and clinical vertebrae and found that administrative data are generally useful for the surveillance of osteoporosis-related fractures although the validity depends on the fracture site and features of the algorithm [6].…”

Emergency Department Visits after Diagnosed Chronic Obstructive Pulmonary Disease in Aboriginal People in Alberta, Canada

“…19,20 We used validated case algorithms to identify the following comorbidities that have been associated with an increase in health services use in COPD patients: hypertension, 21,22 diabetes mellitus, 23 ischemic heart disease, 24 asthma, 25 and osteoporosis. 26 Annual rates of all-cause ED visits were calculated from fiscal years 2002 to 2009. The numerator was the number of episodes of ED care per person per year and the denominator was the person-time of observation, defined as the sum of the time that each person with COPD remained under observation from beginning of the fiscal year (if the person was diagnosed in previous years) or COPD diagnosis date (if the person was diagnosed during the year) until death, or end of fiscal year, whichever came first.…”