Validierung von Sekundärdaten

Hoffmann, Falk; Andersohn, Frank; Giersiepen, Klaus; Scharnetzky, Elke; Garbe, Edeltraut

doi:10.1007/s00103-008-0646-y

Cited by 54 publications

(26 citation statements)

References 32 publications

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“…On the other hand, validity of diagnoses should be considered [40]. Although we studied newly diagnosed patients, we know that the coding of dementia diagnoses is made rather late due to taboo, stigmatization, difficulty in the diagnostic process, and poor therapeutic options [41-43].…”

Section: Discussionmentioning

confidence: 99%

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Diagnoses indicating pain and analgesic drug prescription in patients with dementia: a comparison to age- and sex-matched controls

et al. 2014

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BackgroundThe evidence of undertreatment of pain in patients with dementia is inconsistent. This may largely be due to methodological differences and shortcomings of studies. In a large cohort of patients with incident dementia and age- and sex-matched controls we examined (1) how often they receive diagnoses indicating pain, (2) how often they receive analgesics and (3) in which agents and formulations.MethodsUsing health insurance claims data we identified 1,848 patients with a first diagnosis of dementia aged ≥ 65 years and 7,385 age- and sex-matched controls. We analysed differences in diagnoses indicating pain and analgesic drugs prescribed between these two groups within the incidence year. We further fitted logistic regression models and stepwise adjusted for several covariates to study the relation between dementia and analgesics.ResultsOn average, patients were 78.7 years old (48% female). The proportions receiving at least one diagnosis indicating pain were similar between the dementia and control group (74.4% vs. 72.5%; p = 0.11). The proportion who received analgesics was higher in patients with dementia in the crude analysis (47.5% vs. 44.7%; OR: 1.12; 95% CI: 1.01-1.24), but was significantly lower when adjusted for socio-demographic variables, care dependency, comorbidities and diagnoses indicating pain (OR: 0.78; 95% CI: 0.68-0.88). Analgesics in liquid form such as metamizole and tramadol were more often used in dementia.ConclusionsOur findings show a comparable documentation of diagnoses indicating pain in persons with incident dementia compared to those without. However, there still seems to be an undertreatment of pain in patients with dementia. Irrespective of dementia, analgesics seem to be more often prescribed to sicker patients and to control pain in the context of mobility.

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Section: Discussionmentioning

confidence: 99%

“…However, pain identification and management of pain should not be severely impaired by the absence of a precise etiological dementia diagnosis. In Germany, validation studies are scarce [40] and no data on the validity of the dementia diagnosis as well as of the types of pain are available.…”

Section: Discussionmentioning

confidence: 99%

Diagnoses indicating pain and analgesic drug prescription in patients with dementia: a comparison to age- and sex-matched controls

et al. 2014

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“…Another study reported ICD-coding to be reliable on chapter level only and found relevant coding uncertainties at three- and four-digit coding level, too (kappa-values of approximately 0.4 and 0.2 for three-digit and four-digit coding, respectively) [24]. Until now, there have been few validation studies for routine data of German statutory health insurances [25]. That is why we can only estimate the true underlying number of children with each ICD 10 diagnosis as well as the true underlying number of children with pain or activity limitations.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of diagnosis and direct treatment costs of back disorders in 644,773 children and youths in Germany

Ochsmann

Pinzón

Letzel

et al. 2010

BMC Musculoskelet Disord

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BackgroundMany authors have reported about the high prevalence rates of self-reported back pain in children. Nevertheless, little is known about the diagnosis of back disorders - regardless of whether the diagnosis is associated with back pain or not. Therefore, the aim of this study was to analyse the prevalence rates and costs of diagnosis of back disorders in childhood and youth.MethodsWe conducted a secondary data analysis of a large, population based German data set (2,300,980 insurants of statutory health insurance funds) which allowed for identification of prevalence rates of diagnoses of back disorders in children (age group 0-14 years) and youths (age group 15-24 years) using three digit ICD-10 codes for dorsopathies (M40 - M54: kyphosis and lordosis; scoliosis; spinal osteochondrosis; other deforming dorsopathies; ankylosing spondylitis; other inflammatory spondylopathies; spondylosis; other spondylopathies; spondylopathies in diseases classified elsewhere; cervical disc disorders; other intervertebral disc disorders; other dorsopathies, not elsewhere classified; dorsalgia). Direct treatment costs were calculated based on the real incurred costs for cases with a singular diagnosis of a back disorder. Wherever possible, the results of the random sample were extrapolated to all insurants of statutory health insurance funds (i. e., about 90% of the German population).ResultsWe found prevalence rates for the diagnosis of back disorders to range between 0.01 - 12.5%. "Scoliosis" (M41) and "dorsalgia" (M54) were the most frequent diagnoses in both age groups. Based on these results, it was calculated that in 2002 alone, approximately 1.4 million children/youths in Germany were diagnosed with "dorsalgia" (M54), and that the direct costs for back disorders in childhood and youth accounted for at least 100 million Euros.ConclusionsInstead of focusing on the individual, and self-reported disorder or disability, this analysis allowed for the detailed evaluation of medical experts' opinion on back disorders in childhood and youth and for a more objective or public health oriented insight in the topic of diagnosis of back pain and other back disorders. However, due to the methodological limitations by using ICD-10 coding, standardized random validity checks of population based data sets should be mandatory.

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“…Größe, Gewicht, Laborparameter oder Tumorstadium) ist nicht vorhanden. Eine weitere Einschränkung betrifft die Validität dieser Daten, ein Aspekt, zu dem aus Deutschland bisher viel zu wenig bekannt ist [23]. Eine wichtige Voraussetzung, um Forschung praktikabel zu machen, ist die elektronische Erfassung der Daten.…”

Section: Routinedaten Der Krankenkassenunclassified