Lina H Al-Sakran1, Ruth Ann Marrie2, David F Blackburn1, Katherine B Knox3, Charity D Evans1. 1. 1College of Pharmacy and Nutrition,University of Saskatchewan,Saskatoon,SK,Canada. 2. 2Departments of Internal Medicine and Community Health Sciences,University of Manitoba,Winnipeg,MB,Canada. 3. 3College of Medicine (Physical Medicine and Rehabilitation),University of Saskatchewan,Saskatoon,SK,Canada.
Abstract
OBJECTIVE: To validate a case definition of multiple sclerosis (MS) using health administrative data and to provide the first province-wide estimates of MS incidence and prevalence for Saskatchewan, Canada. METHODS: We used population-based health administrative data between January 1, 1996 and December 31, 2015 to identify individuals with MS using two potential case definitions: (1) ≥3 hospital, physician, or prescription claims (Marrie definition); (2) ≥1 hospitalization or ≥5 physician claims within 2 years (Canadian Chronic Disease Surveillance System [CCDSS] definition). We validated the case definitions using diagnoses from medical records (n=400) as the gold standard. RESULTS: The Marrie definition had a sensitivity of 99.5% (95% confidence interval [CI] 92.3-99.2), specificity of 98.5% (95% CI 97.3-100.0), positive predictive value (PPV) of 99.5% (95% CI 97.2-100.0), and negative predictive value (NPV) of 97.5% (95% CI 94.4-99.2). The CCDSS definition had a sensitivity of 91.0% (95% CI 81.2-94.6), specificity of 99.0% (95% CI 96.4-99.9), PPV of 98.9% (95% CI 96.1-99.9), and NPV of 91.7% (95% CI 87.2-95.0). Using the more sensitive Marrie definition, the average annual adjusted incidence per 100,000 between 2001 and 2013 was 16.5 (95% CI 15.8-17.2), and the age- and sex-standardized prevalence of MS in Saskatchewan in 2013 was 313.6 per 100,000 (95% CI 303.0-324.3). Over the study period, incidence remained stable while prevalence increased slightly. CONCLUSION: We confirm Saskatchewan has one of the highest rates of MS in the world. Similar to other regions in Canada, incidence has remained stable while prevalence has gradually increased.
OBJECTIVE: To validate a case definition of multiple sclerosis (MS) using health administrative data and to provide the first province-wide estimates of MS incidence and prevalence for Saskatchewan, Canada. METHODS: We used population-based health administrative data between January 1, 1996 and December 31, 2015 to identify individuals with MS using two potential case definitions: (1) ≥3 hospital, physician, or prescription claims (Marrie definition); (2) ≥1 hospitalization or ≥5 physician claims within 2 years (Canadian Chronic Disease Surveillance System [CCDSS] definition). We validated the case definitions using diagnoses from medical records (n=400) as the gold standard. RESULTS: The Marrie definition had a sensitivity of 99.5% (95% confidence interval [CI] 92.3-99.2), specificity of 98.5% (95% CI 97.3-100.0), positive predictive value (PPV) of 99.5% (95% CI 97.2-100.0), and negative predictive value (NPV) of 97.5% (95% CI 94.4-99.2). The CCDSS definition had a sensitivity of 91.0% (95% CI 81.2-94.6), specificity of 99.0% (95% CI 96.4-99.9), PPV of 98.9% (95% CI 96.1-99.9), and NPV of 91.7% (95% CI 87.2-95.0). Using the more sensitive Marrie definition, the average annual adjusted incidence per 100,000 between 2001 and 2013 was 16.5 (95% CI 15.8-17.2), and the age- and sex-standardized prevalence of MS in Saskatchewan in 2013 was 313.6 per 100,000 (95% CI 303.0-324.3). Over the study period, incidence remained stable while prevalence increased slightly. CONCLUSION: We confirm Saskatchewan has one of the highest rates of MS in the world. Similar to other regions in Canada, incidence has remained stable while prevalence has gradually increased.
Authors: Ruth Ann Marrie; John D Fisk; Randy Walld; James M Bolton; Jitender Sareen; Scott B Patten; Alexander Singer; Lisa M Lix; Carol A Hitchon; Renée El-Gabalawy; Alan Katz; James J Marriott; Charles N Bernstein Journal: Front Neurol Date: 2022-04-14 Impact factor: 4.086
Authors: William J Culpepper; Ruth Ann Marrie; Annette Langer-Gould; Mitchell T Wallin; Jonathan D Campbell; Lorene M Nelson; Wendy E Kaye; Laurie Wagner; Helen Tremlett; Lie H Chen; Stella Leung; Charity Evans; Shenzhen Yao; Nicholas G LaRocca Journal: Neurology Date: 2019-02-15 Impact factor: 9.910
Authors: C Blaney; J Sommer; R El-Gabalawy; C Bernstein; R Walld; C Hitchon; J Bolton; J Sareen; S Patten; A Singer; L Lix; A Katz; J Fisk; R A Marrie Journal: Epidemiol Psychiatr Sci Date: 2020-01-09 Impact factor: 6.892
Authors: Anna Iljicsov; Dániel Milanovich; András Ajtay; Ferenc Oberfrank; Mónika Bálint; Balázs Dobi; Dániel Bereczki; Magdolna Simó Journal: PLoS One Date: 2020-07-27 Impact factor: 3.240