| アブストラクト | OBJECTIVE: To identify characteristics that predict a valid rheumatoid arthritis (RA) or juvenile idiopathic arthritis (JIA) diagnosis among RA- and JIA-coded individuals in the General Practice Research Database (GPRD), and to assess limitations of this type of diagnostic validation. METHODS: Four RA and 2 JIA diagnostic groups were created with differing strengths of evidence of RA/JIA (Group 1 = strongest evidence), based on RA/JIA medical codes. Individuals were sampled from each group and clinical and prescription data were extracted from anonymized hospital/practice correspondence and electronic records. American College of Rheumatology and International League of Associations for Rheumatology diagnostic criteria were used to validate diagnoses. A data-derived diagnostic algorithm that maximized sensitivity and specificity was identified using logistic regression. RESULTS: Among 223 RA-coded individuals, the diagnostic algorithm classified individuals as having RA if they had an appropriate GPRD disease-modifying antirheumatic drug prescription or 3 other GPRD characteristics: >1 RA code during followup, RA diagnostic Group 1 or 2, and no later alternative diagnostic code. This algorithm had >80% sensitivity and specificity when applied to a test data set. Among 101 JIA-coded individuals, the strongest predictor of a valid diagnosis was a Group 1 diagnostic code (>90% sensitivity and specificity). CONCLUSION: Validity of an RA diagnosis among RA-coded GPRD individuals appears high for patients with specific characteristics. The findings are important for both interpreting results of published GPRD studies and identifying RA/JIA patients for future GPRD-based research. However, several limitations were identified, and further debate is needed on how best to validate chronic disease diagnoses in the GPRD. |
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| ジャーナル名 | Arthritis and rheumatism |
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| 投稿日 | 2008/9/2 |
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| 投稿者 | Thomas, S L; Edwards, C J; Smeeth, L; Cooper, C; Hall, A J |
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| 組織名 | Department of Epidemiology & Population Health, London School of Hygiene &;Tropical Medicine, Keppel Street, London WC1E 7HT, UK. sara.thomas@lshtm.ac.uk |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/18759262/ |
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