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Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada
INTRODUCTION: Case-finding algorithms can be applied to administrative healthcare records to identify people with diseases, including people with HIV (PWH). When supplementing an existing registry of a low prevalence disease, near-perfect specificity helps minimize impacts of adding in algorithm-ide...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470893/ https://www.ncbi.nlm.nih.gov/pubmed/37651428 http://dx.doi.org/10.1371/journal.pone.0290777 |
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author | Emerson, Scott D. McLinden, Taylor Sereda, Paul Lima, Viviane D. Hogg, Robert S. Kooij, Katherine W. Yonkman, Amanda M. Salters, Kate A. Moore, David Toy, Junine Wong, Jason Consolacion, Theodora Montaner, Julio S. G. Barrios, Rolando |
author_facet | Emerson, Scott D. McLinden, Taylor Sereda, Paul Lima, Viviane D. Hogg, Robert S. Kooij, Katherine W. Yonkman, Amanda M. Salters, Kate A. Moore, David Toy, Junine Wong, Jason Consolacion, Theodora Montaner, Julio S. G. Barrios, Rolando |
author_sort | Emerson, Scott D. |
collection | PubMed |
description | INTRODUCTION: Case-finding algorithms can be applied to administrative healthcare records to identify people with diseases, including people with HIV (PWH). When supplementing an existing registry of a low prevalence disease, near-perfect specificity helps minimize impacts of adding in algorithm-identified false positive cases. We evaluated the performance of algorithms applied to healthcare records to supplement an HIV registry in British Columbia (BC), Canada. METHODS: We applied algorithms based on HIV-related diagnostic codes to healthcare practitioner and hospitalization records. We evaluated 28 algorithms in a validation sub-sample of 7,124 persons with positive HIV tests (2,817 with a prior negative test) from the STOP HIV/AIDS data linkage–a linkage of healthcare, clinical, and HIV test records for PWH in BC, resembling a disease registry (1996–2020). Algorithms were primarily assessed based on their specificity–derived from this validation sub-sample–and their impact on the estimate of the total number of PWH in BC as of 2020. RESULTS: In the validation sub-sample, median age at positive HIV test was 37 years (Q1: 30, Q3: 46), 80.1% were men, and 48.9% resided in the Vancouver Coastal Health Authority. For all algorithms, specificity exceeded 97% and sensitivity ranged from 81% to 95%. To supplement the HIV registry, we selected an algorithm with 99.89% (95% CI: 99.76% - 100.00%) specificity and 82.21% (95% CI: 81.26% - 83.16%) sensitivity, requiring five HIV-related healthcare practitioner encounters or two HIV-related hospitalizations within a 12-month window, or one hospitalization with HIV as the most responsible diagnosis. Upon adding PWH identified by this highly-specific algorithm to the registry, 8,774 PWH were present in BC as of March 2020, of whom 333 (3.8%) were algorithm-identified. DISCUSSION: In the context of an existing low prevalence disease registry, the results of our validation study demonstrate the value of highly-specific case-finding algorithms applied to administrative healthcare records to enhance our ability to estimate the number of PWH living in BC. |
format | Online Article Text |
id | pubmed-10470893 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-104708932023-09-01 Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada Emerson, Scott D. McLinden, Taylor Sereda, Paul Lima, Viviane D. Hogg, Robert S. Kooij, Katherine W. Yonkman, Amanda M. Salters, Kate A. Moore, David Toy, Junine Wong, Jason Consolacion, Theodora Montaner, Julio S. G. Barrios, Rolando PLoS One Research Article INTRODUCTION: Case-finding algorithms can be applied to administrative healthcare records to identify people with diseases, including people with HIV (PWH). When supplementing an existing registry of a low prevalence disease, near-perfect specificity helps minimize impacts of adding in algorithm-identified false positive cases. We evaluated the performance of algorithms applied to healthcare records to supplement an HIV registry in British Columbia (BC), Canada. METHODS: We applied algorithms based on HIV-related diagnostic codes to healthcare practitioner and hospitalization records. We evaluated 28 algorithms in a validation sub-sample of 7,124 persons with positive HIV tests (2,817 with a prior negative test) from the STOP HIV/AIDS data linkage–a linkage of healthcare, clinical, and HIV test records for PWH in BC, resembling a disease registry (1996–2020). Algorithms were primarily assessed based on their specificity–derived from this validation sub-sample–and their impact on the estimate of the total number of PWH in BC as of 2020. RESULTS: In the validation sub-sample, median age at positive HIV test was 37 years (Q1: 30, Q3: 46), 80.1% were men, and 48.9% resided in the Vancouver Coastal Health Authority. For all algorithms, specificity exceeded 97% and sensitivity ranged from 81% to 95%. To supplement the HIV registry, we selected an algorithm with 99.89% (95% CI: 99.76% - 100.00%) specificity and 82.21% (95% CI: 81.26% - 83.16%) sensitivity, requiring five HIV-related healthcare practitioner encounters or two HIV-related hospitalizations within a 12-month window, or one hospitalization with HIV as the most responsible diagnosis. Upon adding PWH identified by this highly-specific algorithm to the registry, 8,774 PWH were present in BC as of March 2020, of whom 333 (3.8%) were algorithm-identified. DISCUSSION: In the context of an existing low prevalence disease registry, the results of our validation study demonstrate the value of highly-specific case-finding algorithms applied to administrative healthcare records to enhance our ability to estimate the number of PWH living in BC. Public Library of Science 2023-08-31 /pmc/articles/PMC10470893/ /pubmed/37651428 http://dx.doi.org/10.1371/journal.pone.0290777 Text en © 2023 Emerson et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Emerson, Scott D. McLinden, Taylor Sereda, Paul Lima, Viviane D. Hogg, Robert S. Kooij, Katherine W. Yonkman, Amanda M. Salters, Kate A. Moore, David Toy, Junine Wong, Jason Consolacion, Theodora Montaner, Julio S. G. Barrios, Rolando Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada |
title | Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada |
title_full | Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada |
title_fullStr | Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada |
title_full_unstemmed | Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada |
title_short | Identification of people with low prevalence diseases in administrative healthcare records: A case study of HIV in British Columbia, Canada |
title_sort | identification of people with low prevalence diseases in administrative healthcare records: a case study of hiv in british columbia, canada |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470893/ https://www.ncbi.nlm.nih.gov/pubmed/37651428 http://dx.doi.org/10.1371/journal.pone.0290777 |
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