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BMC Pulmonary Medicine
Published in: BMC Pulmonary Medicine 1/2017

Open Access 01-12-2017 | Research article

Can healthcare utilization data reliably capture cases of chronic respiratory diseases? a cross-sectional investigation in Italy

Authors: A Biffi, R Comoretto, A Arfè, L Scotti, L Merlino, A Vaghi, A Pesci, R de Marco, G Corrao, on behalf of the “CRD Real-World Evidence” scientific board

Published in: BMC Pulmonary Medicine | Issue 1/2017

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Abstract

Background

Healthcare utilization data are increasingly used for chronic disease surveillance. Nevertheless, no standard criteria for estimating prevalence of high-impact diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are available. In this study an algorithm for recognizing COPD/asthma cases from HCU data is developed and implemented in the HCU databases of the Italian Lombardy Region (about 10 million residents). The impact of diagnostic misclassification for reliably estimating prevalence was also assessed.

Methods

Disease-specificdrug codes, hospital discharges together with co-payment exemptions when available, and a combination of them according with patient’s age, were used to create the proposed algorithm. Identified cases were considered for prevalence estimation. An external validation study was also performed in order to evaluate systematic uncertainty of prevalence estimates.

Results

Raw prevalence of COPD and asthma in 2010 was 3.6 and 3.3% respectively. According to external validation, sensitivity values were 53% for COPD and 39% for asthma. Adjusted prevalence estimates were respectively 6.8 and 8.5% for COPD (among person aged 40 years or older) and asthma (among person aged 40 years or younger).

Conclusions

COPD and asthma prevalence may be estimated from HCU data, albeit with high systematic uncertainty. Validation is recommended in this setting.
Appendix
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Metadata
Title
Can healthcare utilization data reliably capture cases of chronic respiratory diseases? a cross-sectional investigation in Italy
Authors
A Biffi
R Comoretto
A Arfè
L Scotti
L Merlino
A Vaghi
A Pesci
R de Marco
G Corrao
on behalf of the “CRD Real-World Evidence” scientific board
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2017
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-016-0362-6

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