The Accuracy of Administrative Data Diagnoses of Systemic Autoimmune Rheumatic Diseases

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DateAugust 31, 2013
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ABSTRACT

Objective.
To examine the validity of case definitions for systemic autoimmune rheumatic diseases
[SARD; systemic lupus erythematosus (SLE), systemic sclerosis (SSc), myositis, Sjögren’s syndrome,
vasculitis, and polymyalgia rheumatica] based on administrative data, compared to rheumatology
records.

Methods. A list of rheumatic disease diagnoses was generated from population-based administrative
billing and hospitalization databases. Subjects who had been seen by an arthritis center rheumatologist
were identified, and the medical records reviewed.

Results. We found that 844 Nova Scotia residents had a diagnosis of one of the rheumatic diseases of
interest, based on administrative data, and had had ≥ 1 rheumatology assessment at a provincial arthritis
center. Charts were available on 824 subjects, some of whom had been identified in the administrative
database with > 1 diagnosis. Thus a total of 1136 diagnoses were available for verification against
clinical records. Of the 824 subjects, 680 (83%) had their administrative database diagnoses confirmed
on chart review. The majority of subjects who were “false-positive” for a given rheumatic disease on
administrative data had a true diagnosis of a similar rheumatic disease. Most sensitivity estimates for
specific administrative data-based case definitions were > 90%, although for SSc, the sensitivity was
80.5%. The specificity estimates were also > 90%, except for SLE, where the specificity was 72.5%.

Conclusion.
Although health administrative data may be a valid resource, there are potential problems
regarding the specificity and sensitivity of case definitions, which should be kept in mind for future
studies.

(J Rheumatol First Release May 1 2011; doi:10.3899/jrheum.101149)