Validation of algorithms to determine incidence of Hirschsprung disease in Ontario, Canada: a population-based study using health administrative data

Nasr, Ahmed; Sullivan, Katrina; Chan, Emily; Wong, Coralie A; Benchimol, Eric I

doi:10.2147/clep.s148890

Cited by 11 publications

(2 citation statements)

References 26 publications

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“…To identify children born with HD between fiscal years (FY) 1991 to 2013 (April 1, 1991 to March 31, 2014), we used a previously validated algorithm, which relied on the presence of a hospitalization with diagnostic code for HD, plus a surgical or biopsy code for HD-related procedure. This identified patients with HD from within Ontario health administrative data with the following diagnostic accuracy: sensitivity 93.5%, specificity >99.9%, positive predictive value 89.6% and negative predictive value >99.9% ( 10 ).…”

Section: Methodsmentioning

confidence: 99%

Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

Nasr

Grandpierre

Sullivan

et al. 2020

Journal of the Canadian Association of Gastroenterology

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Background The only curative treatment for Hirschsprung disease (HD) is surgical repair. However, some patients experience poor postoperative outcomes. We determined long-term outcomes of all HD patients in Ontario, Canada’s most populous province. Methods We conducted a retrospective cohort study including all children with HD born between April 1, 1991 and March 31, 2014 in Ontario using linked health administrative data. Each HD case was matched to five non-HD controls on sex, date of birth, region of residence and income and followed to March 31, 2016. Chronic diarrhea and constipation were identified using combinations of outpatient physician billing codes in both HD patients and non-HD residents of the province. We determined risk factors associated with diarrhea and constipation, including surgery type and sociodemographic characteristics, using multivariable conditional logistic regression, and reported adjusted odds ratios (aORs). Results There were 3,265,172 children born in the study period, of whom 673 had HD. Compared to controls, chronic constipation was more common in HD patients (27.5% versus 2.1%; aOR 17.2, 95% CI 12.6 to 23.4), as was chronic diarrhea (29.9% versus 6.9%, aOR 5.22, 95% CI 4.19 to 6.50). In HD patients, older age at surgery was associated with increased risk of chronic constipation (OR 2.71, 95% CI 1.75 to 4.20). Surgery type, sex, rural/urban residence and income were not associated with risk of chronic constipation or diarrhea. Conclusion Chronic constipation and diarrhea were common following surgery for HD. Older age at surgery was associated with subsequent risk of chronic constipation. Surgery type was not associated with increased risk of chronic constipation or diarrhea.

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Section: Methodsmentioning

confidence: 99%

Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

Nasr

Grandpierre

Sullivan

et al. 2020

Journal of the Canadian Association of Gastroenterology

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“…A typical case definition algorithm might include/exclude specific diagnostic codes, health encounters, and/or include a specific number of data sources in which diagnoses appear (refer to Table 1 ). Although this approach has proven to be an effective way to monitor disease status (J. Salemi, Rutkowski, Tanner, Matas, & Kirby, 2018 ; Kharbanda et al, 2017 ; Shiff, Oen, Rabbani, & Lix, 2017 ; Nasr, Sullivan, Chan, Wong, & Benchimol, 2017 ), it is important to note that the development of standardized case definition algorithms can be challenging because of jurisdictional differences, differences in disease classification nomenclature, revisions in disease classification coding systems over time (Johnson & Nelson, 2013 ; Shiff et al, 2017 ) and concerns about the validity of diagnostic codes (Farr et al, 2021 ). Also, differences in presentation and severity of CA result in diagnostic variability, which influences ascertainment (Langlois, Sheu, & Scheuerle, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Validation of case definition algorithms for the ascertainment of congenital anomalies

Escalante

Abayomi

Langlois

et al. 2022

Birth Defects Research

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Background Congenital anomalies (CA) are one of the leading causes of infant mortality and long‐term disability. Many jurisdictions rely on health administrative data to monitor these conditions. Case definition algorithms can be used to monitor CA; however, validation of these algorithms is needed to understand the strengths and limitations of the data. This study aimed to validate case definition algorithms used in a CA surveillance system in British Columbia (BC), Canada. Methods A cohort of births between March 2000 and April 2002 in BC was linked to the Health Status Registry (HSR) and the BC Congenital Anomalies Surveillance System (BCCASS) to identify cases and non‐cases of specific anomalies within each surveillance system. Measures of algorithm performance were calculated for each CA using the HSR as the reference standard. Agreement between both databases was calculated using kappa coefficient. The modified Standards for Reporting Diagnostic Accuracy guidelines were used to enhance the quality of the study. Results Measures of algorithm performance varied by condition. Positive predictive value (PPV) ranged between approximately 73%–100%. Sensitivity was lower than PPV for most conditions. Internal congenital anomalies or conditions not easily identifiable at birth had the lowest sensitivity. Specificity and negative predictive value exceeded 99% for all algorithms. Conclusion Case definition algorithms may be used to monitor CA at the population level. Accuracy of algorithms is higher for conditions that are easily identified at birth. Jurisdictions with similar administrative data may benefit from using validated case definitions for CA surveillance as this facilitates cross‐jurisdictional comparison.

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Development and validation of an algorithm of diagnostic and procedural codes for the identification of children hospitalized with a tracheostomy in Ontario, Canada

McKelvie

Pianosi

Chan

et al. 2020

Pediatric Pulmonology

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BackgroundThe requirement for a tracheostomy in children is associated with significant morbidity, mortality, and healthcare utilization. Easy identification of children with tracheostomies would facilitate important research on this population and provide quality improvement initiatives.AimThe purpose of this study is to determine whether an algorithm of diagnostic and procedural codes can accurately identify children hospitalized with a tracheostomy using routinely collected health data.MethodsChart reviews were performed at the Children's Hospital of Eastern Ontario (CHEO) and the London Health Sciences Center (LHSC) to establish a true positive cohort of pediatric patients with tracheostomies admitted between 2008 and 2016. A multidisciplinary team developed algorithms of diagnostic and procedural codes contained within the Canadian Institute for Health Information Discharge Abstract Database. Algorithms were tested and refined against the true‐positive and true‐negative cohort. The accuracy of the diagnostic codes related to tracheostomy complications was also evaluated.ResultsA chart review identified 158 unique children with tracheostomies (77 at CHEO, 81 at LHSC) with 901 individual admissions (401 at CHEO, 507 at LHSC). The best algorithms for identifying children with a tracheostomy had a sensitivity and specificity of more than 99%, a positive predictive value (PPV) of 94.0% and negative predictive value (NPV) of 100%. The algorithm for the identification of tracheostomy‐related complications had a sensitivity of 76.7%, a specificity of 65%, PPV of 52.3%, and an NPV of 84.7%.ConclusionsThis study provides an algorithm for the accurate identification of children hospitalized in Canada with a tracheostomy, facilitating population‐level epidemiological research and quality improvement initiatives.

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Validation of algorithms to determine incidence of Hirschsprung disease in Ontario, Canada: a population-based study using health administrative data

Cited by 11 publications

References 26 publications

Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

Validation of case definition algorithms for the ascertainment of congenital anomalies

Development and validation of an algorithm of diagnostic and procedural codes for the identification of children hospitalized with a tracheostomy in Ontario, Canada

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