Gustav L Jakobsson1, Emil Sternegård1, Ola Olén2,3, Pär Myrelid4,5, Rickard Ljung6, Hans Strid7,8, Jonas Halfvarson9, Jonas F Ludvigsson1,10,11,12. 1. a Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden. 2. b Department of Pediatric Gastroenterology , Sachs' Children's Hospital , Stockholm , Sweden. 3. c Clinical Epidemiology Unit, Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden. 4. d Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden. 5. e Department of Surgery , Linköping University Hospital , Linköping , Sweden. 6. f Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden. 7. g Department of Internal Medicine , Södra Älvsborgs sjukhus , Borås , Sweden. 8. h Institute of Medicine , Sahlgrenska Academy , University of Gothenburg, Gothenburg , Sweden. 9. i Department of Gastroenterology, Faculty of Medicine and Health , Örebro University , Örebro , Sweden. 10. j Department of Pediatrics , Örebro University Hospital , Örebro , Sweden. 11. k Division of Epidemiology and Public Health, School of Medicine , University of Nottingham , Nottingham , UK. 12. l Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA.
Abstract
BACKGROUND: Both the Swedish National Patient Register (NPR) and the Swedish Quality Register for inflammatory bowel disease (IBD, SWIBREG) are important sources of research data and information. However, the validity of a diagnosis of IBD in these registers is unknown. METHODS: Medical charts of 129 randomly selected patients from the NPR and 165 patients registered both in SWIBREG and the NPR were reviewed. Patients were classified according to standardized criteria for ulcerative colitis (UC), Crohn's disease (CD), or IBD unclassified (IBD-U). Positive predictive values (PPVs) for UC, CD, IBD-U (only SWIBREG), or having any form of IBD were then calculated. RESULTS: For cases with ≥2 diagnoses of IBD in the NPR (hospitalizations or non-primary care outpatient visits), the PPV was 93% (95% CI: 87-97) for any IBD, 79% (66-88) for UC and 72% (60-82) for CD. In UC patients with ≥2 UC diagnoses but never a CD diagnosis, the PPV increased to 90% (77-97). The PPV for CD in patients with ≥2 CD diagnoses but never a UC diagnosis was 81% (67-91)). Combining data from SWIBREG (≥1 record) and the NPR (≥1 record), the PPV was 99% for any IBD (97-100), 96% (89-99) for UC, and 90% (82-96) for CD. CONCLUSION: The validity of the UC, CD, and IBD diagnoses is high in the NPR but even higher when cases were identified both in SWIBREG and the NPR. These results underline the need for a well-functioning Swedish Quality Register for IBD as a complement to the NPR.
BACKGROUND: Both the Swedish National Patient Register (NPR) and the Swedish Quality Register for inflammatory bowel disease (IBD, SWIBREG) are important sources of research data and information. However, the validity of a diagnosis of IBD in these registers is unknown. METHODS: Medical charts of 129 randomly selected patients from the NPR and 165 patients registered both in SWIBREG and the NPR were reviewed. Patients were classified according to standardized criteria for ulcerative colitis (UC), Crohn's disease (CD), or IBD unclassified (IBD-U). Positive predictive values (PPVs) for UC, CD, IBD-U (only SWIBREG), or having any form of IBD were then calculated. RESULTS: For cases with ≥2 diagnoses of IBD in the NPR (hospitalizations or non-primary care outpatient visits), the PPV was 93% (95% CI: 87-97) for any IBD, 79% (66-88) for UC and 72% (60-82) for CD. In UC patients with ≥2 UC diagnoses but never a CD diagnosis, the PPV increased to 90% (77-97). The PPV for CD in patients with ≥2 CD diagnoses but never a UC diagnosis was 81% (67-91)). Combining data from SWIBREG (≥1 record) and the NPR (≥1 record), the PPV was 99% for any IBD (97-100), 96% (89-99) for UC, and 90% (82-96) for CD. CONCLUSION: The validity of the UC, CD, and IBD diagnoses is high in the NPR but even higher when cases were identified both in SWIBREG and the NPR. These results underline the need for a well-functioning Swedish Quality Register for IBD as a complement to the NPR.
Entities:
Keywords:
Inflammatory bowel disease; National Patient Register; validation
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