Skip to main content

Advertisement

SpringerLink
Log in

Validation of administrative case ascertainment algorithms for chronic childhood arthritis in Manitoba, Canada

  • Validation studies
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

We validated case ascertainment algorithms for juvenile idiopathic arthritis (JIA) in the provincial health administrative databases of Manitoba, Canada. A population-based pediatric rheumatology clinical database from April 1st 1980 to March 31st 2012 was used to test case definitions in individuals diagnosed at ≤15 years of age. The case definitions varied the number of diagnosis codes (1, 2, or 3), time frame (1, 2 or 3 years), time between diagnoses (ever, >1 day, or ≥8 weeks), and physician specialty. Positive predictive value (PPV), sensitivity, and specificity with 95% confidence intervals (CIs) are reported. A case definition of 1 hospitalization or ≥2 diagnoses in 2 years by any provider ≥8 weeks apart using diagnosis codes for rheumatoid arthritis and ankylosing spondylitis produced a sensitivity of 89.2% (95% CI 86.8, 91.6), specificity of 86.3% (95% CI 83.0, 89.6), and PPV of 90.6% (95% CI 88.3, 92.9) when seronegative enthesopathy and arthropathy (SEA) was excluded as JIA; and sensitivity of 88.2% (95% CI 85.7, 90.7), specificity of 90.4% (95% CI 87.5, 93.3), and PPV of 93.9% (95% CI 92.0, 95.8) when SEA was included as JIA. This study validates case ascertainment algorithms for JIA in Canadian administrative health data using diagnosis codes for both rheumatoid arthritis (RA) and ankylosing spondylitis, to better reflect current JIA classification than codes for RA alone. Researchers will be able to use these results to define cohorts for population-based studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Petty RE, Southwood TR, Manners P et al (2004) International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 31(2):390–392

    PubMed  Google Scholar 

  2. Packham JC, Hall MA (2002) Long-term follow-up of 246 adults with juvenile idiopathic arthritis: education and employment. Rheumatology 41(12):1436–1439

    Article  CAS  PubMed  Google Scholar 

  3. Petty R, Laxer R, Lindsley C et al (2016) Textbook of pediatric rheumatology. Elsevier, Philadelphia

    Google Scholar 

  4. Flato B, Lien G, Smerdel-Ramoya A et al (2009) Juvenile psoriatic arthritis: longterm outcome and differentiation from other subtypes of juvenile idiopathic arthritis. J Rheumatol 36(3):642–650

    Article  PubMed  Google Scholar 

  5. Oen K (2002) Long-term outcomes and predictors of outcomes for patients with juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol 16(3):347–360

    Article  PubMed  Google Scholar 

  6. Oen K, Malleson PN, Cabral DA et al (2002) Disease course and outcome of juvenile rheumatoid arthritis in a multicenter cohort. J Rheumatol 29(9):1989–1999

    PubMed  Google Scholar 

  7. World Health Organization

  8. Benchimol EI, Manuel DG, To T et al (2011) Development and use of reporting guidelines for assessing the quality of validation studies of health administrative data. J Clin Epidemiol 64(8):821–829

    Article  PubMed  Google Scholar 

  9. Petty RE, Southwood TR, Baum J et al (1998) Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 25(10):1991–1994

    CAS  PubMed  Google Scholar 

  10. Brewer EJ, Bass J, Baum J et al (1977) Current proposed revision of JRA Criteria. Arthritis Rheum 20(2 Supplement):195

    PubMed  Google Scholar 

  11. Rosenberg AM, Petty RE (1982) A syndrome of seronegative enthesopathy and arthropathy in children. Arthritis Rheum 25(9):1041–1047

    Article  CAS  PubMed  Google Scholar 

  12. Stringer E, Bernatsky S (2015) Validity of juvenile idiopathic arthritis diagnoses using administrative health data. Rheumatol Int 35(3):575–579

    Article  PubMed  Google Scholar 

  13. Harrold LR, Salman C, Shoor S et al (2013) Incidence and prevalence of juvenile idiopathic arthritis among children in a managed care population, 1996–2009. J Rheumatol 40(7):1218–1225

    Article  PubMed  Google Scholar 

  14. Ehrmann Feldman D, Bernatsky S, Houde M (2007) The incidence of juvenile rheumatoid arthritis in Quebec: a population data-based study. Pediatr Rheumatol 7:20

    Article  Google Scholar 

  15. Shiff NJ, Lix LM, Oen K et al (2015) Chronic inflammatory arthritis prevalence estimates for children and adolescents in three Canadian provinces. Rheumatol Int 35(2):345–350

    Article  PubMed  Google Scholar 

  16. Widdifield J, Bombardier C, Bernatsky S et al (2014) An administrative data validation study of the accuracy of algorithms for identifying rheumatoid arthritis: the influence of the reference standard on algorithm performance. BMC Musculoskelet Disord 15:216

    Article  PubMed  PubMed Central  Google Scholar 

  17. Widdifield J, Bernatsky S, Paterson JM et al (2013) Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists. Arthritis Care Res (Hoboken) 65(10):1582–1591

    Google Scholar 

  18. Lacaille D, Anis AH, Guh DP et al (2005) Gaps in care for rheumatoid arthritis: a population study. Arthritis Rheum 53(2):241–248

    Article  PubMed  Google Scholar 

  19. MacLean CH, Louie R, Leake B et al (2000) Quality of care for patients with rheumatoid arthritis. JAMA 284(8):984–992

    Article  CAS  PubMed  Google Scholar 

  20. Widdifield J, Labrecque J, Lix L et al (2013) Systematic review and critical appraisal of validation studies to identify rheumatic diseases in health administrative databases. Arthritis Care Res (Hoboken) 65(9):1490–1503

    Article  Google Scholar 

  21. Ehrmann Feldman D, Bernatsky S, Abrahamowicz M et al (2008) Consultation with an arthritis specialist for children with suspected juvenile rheumatoid arthritis: a population-based study. Arch Pediatr Adolesc Med 162(6):538–543

    Article  PubMed  Google Scholar 

  22. Hudson M, Suissa S (2010) Avoiding common pitfalls in the analysis of observational studies of new treatments for rheumatoid arthritis. Arthritis Care Res 62(6):805–810

    Article  Google Scholar 

  23. Report from the summit on standards for arthritis prevention and care; November 1–2, 2005, Ottawa, Canada. Homepage on the Internet

  24. Lix LM, Walker R, Quan H et al (2012) Features of physician services databases in Canada. Chronic Dis Inj Can 32(4):186–193

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge the Manitoba Centre for Health Policy for use of data contained in the Population Health Research Data Repository under HIPC project # 2013/2014-19. The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, or other data providers is intended or should be inferred. Administrative health data used in this study are from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba, and were derived from data provided by Manitoba Health and the Winnipeg Regional Health Authority.

Author information

Authors and Affiliations

  1. Division of Immunology, Rheumatology and Allergy, Department of Pediatrics, University of Florida, Box 100296, 1600 SW Archer Road, Gainesville, Florida, 32610, USA

    Natalie Jane Shiff

  2. Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    Natalie Jane Shiff

  3. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada

    Kiem Oen

  4. George and Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada

    Rasheda Rabbani & Lisa M. Lix

  5. Department of Community Health Sciences, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

    Rasheda Rabbani

Authors
  1. Natalie Jane Shiff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiem Oen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rasheda Rabbani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lisa M. Lix
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Natalie Jane Shiff.

Ethics declarations

Funding

This study was funded by a Saskatchewan Health Research Foundation New Investigator Establishment Grant, grant number 412286. LML is supported by a Manitoba Research Chair from Research Manitoba.

Conflict of interest

Natalie Jane Shiff declares that she has no conflict of interest. Kiem Oen declares that she has no conflict of interest. Rasheda Rabbani declares that she has no conflict of interest. Lisa M. Lix declares that she has no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shiff, N.J., Oen, K., Rabbani, R. et al. Validation of administrative case ascertainment algorithms for chronic childhood arthritis in Manitoba, Canada. Rheumatol Int 37, 1575–1584 (2017). https://doi.org/10.1007/s00296-017-3734-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-017-3734-1

Keywords

Search

Navigation