Validation of epilepsy diagnoses in the Danish National Hospital Register

Christensen, Jakob; Vestergaard, Mogens; Olsen, Jørn; Sidenius, Per

doi:10.1016/j.eplepsyres.2007.05.009

Cited by 174 publications

(161 citation statements)

References 21 publications

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“…However, validation studies have shown high quality in diagnoses of febrile seizure, epilepsy, and ADHD obtained in these Danish registers. We found that the predictive value of a febrile seizure diagnosis was 93%, 41 the value of an epilepsy diagnosis was 81%, 42 and the value of an ADHD diagnosis was 84%. 43 We did not include data on diagnoses from private practices (only from public hospital departments).…”

Section: Figurementioning

confidence: 85%

“…Analysis of subtypes of epilepsy was not performed because of the relatively low number of such subtypes in DNHR and because of insufficient discriminate validity of subtype diagnoses of epilepsy in the register. 42 Patients were assigned to the epilepsy group at first onset of epilepsy, regardless of subtype. Furthermore, we did not examine the effect of repeated admissions due to epilepsy or a possible dose-response effect in the association.…”

Section: Figurementioning

confidence: 99%

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Childhood Epilepsy, Febrile Seizures, and Subsequent Risk of ADHD

et al. 2016

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OBJECTIVES: Epilepsy, febrile seizures, and attention-deficit/hyperactivity disorder (ADHD) are disorders of the central nervous system and share common risk factors. Our goal was to examine the association in a nationwide cohort study with prospective follow-up and adjustment for selected confounders. We hypothesized that epilepsy and febrile seizures were associated with subsequent ADHD. METHODS:A population-based cohort of all children born in Denmark from 1990 through 2007 was followed up until 2012. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) for ADHD were estimated by using Cox regression analysis, comparing children with epilepsy and febrile seizure with those without these disorders, adjusted for socioeconomic and perinatal risk factors, as well as family history of neurologic and psychiatric disorders. RESULTS:A total of 906 379 individuals were followed up for 22 years (∼10 million personyears of observation); 21 079 individuals developed ADHD. Children with epilepsy had a fully adjusted IRR of ADHD of 2.72 (95% CI, 2.53-2.91) compared with children without epilepsy. Similarly, in children with febrile seizure, the fully adjusted IRR of ADHD was 1.28 (95% CI, 1.20-1.35). In individuals with both epilepsy and febrile seizure, the fully adjusted IRR of ADHD was 3.22 (95% CI, 2.72-3.83). CONCLUSIONS:Our findings indicate a strong association between epilepsy in childhood and, to a lesser extent, febrile seizure and subsequent development of ADHD, even after adjusting for socioeconomic and perinatal risk factors, and family history of epilepsy, febrile seizures, or psychiatric disorders. Ms Bertelsen conceptualized and designed the study, conducted the initial analyses, and drafted the initial manuscript; Ms Larsen conducted the initial analyses and critically reviewed the manuscript; Dr Petersen supervised the initial analyses and critically reviewed the manuscript; Dr Christensen conceptualized and designed the study, helped draft the initial manuscript, and critically reviewed the manuscript; Dr Dalsgaard conceptualized and designed the study, helped draft the initial manuscript, and critically reviewed the manuscript; and all authors approved the fi nal manuscript as submitted. WHAT'S KNOWN ON THIS SUBJECT:Several studies have demonstrated an association between seizure disorders and attention-defi cit/hyperactivity disorder in childhood. Genetic and environmental risk factors infl uence this association, but former studies on this subject have been limited by retrospective designs and small sample sizes. WHAT THIS STUDY ADDS:This prospective population-based study found a strong association between childhood epilepsy and febrile seizures and subsequent attention-defi cit/hyperactivity disorder, even after adjusting for perinatal and socioeconomic risk factors, as well as family history of neurologic and psychiatric disorders.by guest on May 9, 2018 http://pediatrics.aappublications.org/ Downloaded from BERTELSEN et alThe population prevalence of epilepsy has been esti...

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Section: Figurementioning

confidence: 85%

Section: Figurementioning

confidence: 99%

Childhood Epilepsy, Febrile Seizures, and Subsequent Risk of ADHD

et al. 2016

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“…The validity of the diagnoses in the registry has been studied for several diseases (eg, epilepsy, asthma, and febrile seizures, with positive predictive values of 81%, 85%, and 93%, respectively). [20][21][22][23][24] Diagnoses, based on the Danish version of the ICD-10, 25 were classified into dichotomous diagnostic categories according to chapters 1 to 17 of the ICD-10. In addition, we used as outcome a dichotomous overall category ("any disease"), indicating whether any disease of any diagnostic category was present (see also refs 26 and 27).…”

Section: Child Diseasesmentioning

confidence: 99%

Asthma During Pregnancy and Clinical Outcomes in Offspring: A National Cohort Study

Tegethoff¹,

Olsen

Schaffner

et al. 2013

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Asthma is a common medical complication during pregnancy that is associated with an increased risk of adverse obstetric outcomes. WHAT THIS STUDY ADDS:This study adds knowledge on potential long-term consequences of maternal asthma during pregnancy for offspring health, demonstrating that maternal asthma during pregnancy is linked to a wide spectrum of offspring diseases during childhood. abstract BACKGROUND AND OBJECTIVE: Maternal asthma is a common pregnancy complication, with adverse short-term effects for the offspring. The objective was to determine whether asthma during pregnancy is a risk factor of offspring diseases. METHODS:We studied pregnant women from the Danish National Birth Cohort (births: 1996Cohort (births: -2002; prospective data) giving birth to live singletons (n = 66 712 mother-child pairs), with 4145 (6.2%) women suffering from asthma during pregnancy. We estimated the associations between asthma during pregnancy and offspring diseases (International Classification of Diseases, 10th Revision diagnoses from national registries), controlling for potential confounders and validating findings by secondary analyses. RESULTS:Offspring median age at end of follow-up was 6.2 (3.6-8.9) years. Asthma was associated with an increased offspring risk of infectious and parasitic diseases (hazard ratio [HR] 1.34; 95% confidence interval [CI] 1.23-1.46), diseases of the nervous system (HR 1.43; CI 1.18-1.73), ear (HR 1.33; CI 1.19-1.48), respiratory system (HR 1.43; CI 1.34-1.52), and skin (HR 1.39; CI 1.20-1.60), and potentially (not confirmed in secondary analyses) of endocrine and metabolic disorders (HR 1.26; CI 1.02-1.55), diseases of the digestive system (HR 1.17; CI 1.04-1.32), and malformations (odds ratio 1.13; CI 1.01-1.26), but not of neoplasms, mental disorders, or diseases of the blood and immune system, circulatory system, musculoskeletal system, and genitourinary system. CONCLUSIONS:To the best of our knowledge, this is the first comprehensive study of the associations between asthma during pregnancy and a wide spectrum of offspring diseases. In line with previous data on selected outcomes, asthma during pregnancy may be a risk factor for numerous offspring diseases, suggesting that careful monitoring of women with asthma during pregnancy and their offspring is important. Dr Tegethoff conceptualized and designed the study, carried out the statistical analyses, interpreted data, drafted the initial manuscript, critically reviewed the manuscript, and obtained funding; Dr Olsen acquired data, interpreted data, critically reviewed the manuscript, and obtained funding; Mr Schaffner carried out the statistical analyses, interpreted data, and critically reviewed the manuscript; Dr Meinlschmidt conceptualized and designed the study, carried out the statistical analyses, interpreted data, critically reviewed the manuscript, and obtained funding; and all authors approved the final manuscript as submitted. Asthma is a frequently occurring medical condition in pregnancy, ...

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“…21 A study in Denmark (a country with similar national register-based health care to Sweden) found a positive predictive value for epilepsy of 81% and for any seizure disorder of 89%. 22 According to the Danish validation study of the ICD codes for different specific epilepsies in Health Care Registers, their predictive value is low in the subgroups. 22 The occurrence of the specific epilepsy diagnosis varied in different studies of individuals with ASD and comorbid epilepsy, primarily generalized between 14% and 24%, partial onset between 30% and 44%, and the dominating group had unspecified epilepsy (G40.9).…”

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confidence: 99%

“…22 According to the Danish validation study of the ICD codes for different specific epilepsies in Health Care Registers, their predictive value is low in the subgroups. 22 The occurrence of the specific epilepsy diagnosis varied in different studies of individuals with ASD and comorbid epilepsy, primarily generalized between 14% and 24%, partial onset between 30% and 44%, and the dominating group had unspecified epilepsy (G40.9). 6,9,23 We have therefore not analyzed the different epilepsy codes separately.…”

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confidence: 99%

Autism and epilepsy

et al. 2016

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Objective: To investigate the risk of autism spectrum disorder (ASD) in individuals with epilepsy and in their first-degree relatives to determine shared etiology.Methods: Through the Swedish Patient Register, we identified 85,201 individuals with epilepsy, as well as all their siblings (n 5 80,511) and offspring (n 5 98,534). Each individual with epilepsy was compared with 5 controls, matched for age, sex, calendar period, and county, while siblings and offspring were compared with siblings and offspring of controls. We excluded siblings and offspring with epilepsy. Using Cox regression, we calculated hazard ratios (HRs) for future diagnosis of ASD. Logistic regression was applied to calculate odds ratios (ORs) for prior diagnosis of ASD.Results: During follow-up, 1,381 (1.6%) individuals with epilepsy and 700 (0.2%) controls were diagnosed with ASD. Individuals with epilepsy were therefore at increased risk of future ASD (HR 10.49, 95% confidence interval [CI] 9.55-11.53), with the highest risk seen in individuals diagnosed with epilepsy in childhood. Both siblings (HR 1.62, 95% CI 1.43-1.83) and offspring (HR 1.64, 95% CI 1.46-1.84) of epilepsy patients were at increased risk of ASD. The risk in the offspring was particularly high in mothers with epilepsy (HR 1.91; 95% CI 1.63-2.23). Epilepsy was also associated with a prior diagnosis of ASD (OR 4.56, 95% CI 4.02-5.18). According to the definition of the International League Against Epilepsy, "epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition." Conclusions:1 Epilepsy frequently co-occurs with psychiatric disturbances, such as mood and anxiety disorders and autism spectrum disorder (ASD). 1 ASD is a neurodevelopmental disorder characterized by impairment in social interaction and communication and restricted, repetitive, or stereotypic behavior, interests, and activities. The strength and nature of the association between epilepsy and ASD have been scarce and difficult to interpret. A US study of health care data, a British psychiatric morbidity survey, and a prospective screening study all found that ASD as a comorbidity in patients with epilepsy had a prevalence between 1.3% and 21% and an odds ratio (OR) between 6 and 22.

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Validation of epilepsy diagnoses in the Danish National Hospital Register

Cited by 174 publications

References 21 publications

Childhood Epilepsy, Febrile Seizures, and Subsequent Risk of ADHD

Childhood Epilepsy, Febrile Seizures, and Subsequent Risk of ADHD

Asthma During Pregnancy and Clinical Outcomes in Offspring: A National Cohort Study

Autism and epilepsy

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