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Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register
BACKGROUND: Osteonecrosis of the jaw (ONJ) is a medical condition associated with antiresorptive drugs, among others, used to treat osteoporosis and bone metastasis. Currently, there is no consensus regarding the definition of ONJ, and no ONJ-specific International Classification of Diseases-10 code...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541712/ https://www.ncbi.nlm.nih.gov/pubmed/23323023 http://dx.doi.org/10.2147/CLEP.S37664 |
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author | Bergdahl, Johan Jarnbring, Fredrik Ehrenstein, Vera Gammelager, Henrik Granath, Fredrik Kieler, Helle Svensson, Madeleine Tell, Grethe S Lagerros, Ylva Trolle |
author_facet | Bergdahl, Johan Jarnbring, Fredrik Ehrenstein, Vera Gammelager, Henrik Granath, Fredrik Kieler, Helle Svensson, Madeleine Tell, Grethe S Lagerros, Ylva Trolle |
author_sort | Bergdahl, Johan |
collection | PubMed |
description | BACKGROUND: Osteonecrosis of the jaw (ONJ) is a medical condition associated with antiresorptive drugs, among others, used to treat osteoporosis and bone metastasis. Currently, there is no consensus regarding the definition of ONJ, and no ONJ-specific International Classification of Diseases-10 code exists. Therefore, register-based studies of this condition may be troublesome. PURPOSE: To evaluate an algorithm ascertaining ONJ cases in an attempt to facilitate future assessments of ONJ in clinical and epidemiological studies. METHODS: By means of the Patient Register and the Prescribed Drug Register, we identified all postmenopausal female residents in Sweden from 2005 through 2009. To identify potential cases of ONJ, we employed an algorithm including the following conditions: periapical abscess with sinus, inflammatory conditions of jaws, alveolitis of jaws, idiopathic aseptic necrosis of bone, osteonecrosis due to drugs, osteonecrosis due to previous trauma, other secondary osteonecrosis, other osteonecrosis, and unspecified osteonecrosis. Women seen at departments of oral and maxillofacial surgery, with at least one of the conditions, were classified as potential cases of ONJ. Conditions in anatomic sites other than the jaw were excluded. Validation was performed through medical record review. Case confirmation was based on the ONJ definition by the American Association of Oral and Maxillofacial Surgeons. The algorithm was evaluated by positive predictive values (PPVs) stratified by diagnosis. RESULTS: For the 87 potential cases identified through our algorithm, the medical records were obtained for 83. The overall PPV was 18% (95% confidence interval (CI) 10%–28%). The highest PPV was observed in osteonecrosis due to drugs (83%, 95% CI 36%–100%). Several diagnoses had a PPV of 0 or were not used at all (periapical abscess with sinus, alveolitis of jaws, idiopathic aseptic necrosis of bone, osteonecrosis due to previous trauma, other secondary osteonecrosis, other osteonecrosis, and unspecified osteonecrosis). CONCLUSION: It was possible to ascertain cases of ONJ from the Swedish registers using this algorithm; however, the PPV was low. Thus, further refinements of the algorithm are necessary. |
format | Online Article Text |
id | pubmed-3541712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-35417122013-01-15 Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register Bergdahl, Johan Jarnbring, Fredrik Ehrenstein, Vera Gammelager, Henrik Granath, Fredrik Kieler, Helle Svensson, Madeleine Tell, Grethe S Lagerros, Ylva Trolle Clin Epidemiol Original Research BACKGROUND: Osteonecrosis of the jaw (ONJ) is a medical condition associated with antiresorptive drugs, among others, used to treat osteoporosis and bone metastasis. Currently, there is no consensus regarding the definition of ONJ, and no ONJ-specific International Classification of Diseases-10 code exists. Therefore, register-based studies of this condition may be troublesome. PURPOSE: To evaluate an algorithm ascertaining ONJ cases in an attempt to facilitate future assessments of ONJ in clinical and epidemiological studies. METHODS: By means of the Patient Register and the Prescribed Drug Register, we identified all postmenopausal female residents in Sweden from 2005 through 2009. To identify potential cases of ONJ, we employed an algorithm including the following conditions: periapical abscess with sinus, inflammatory conditions of jaws, alveolitis of jaws, idiopathic aseptic necrosis of bone, osteonecrosis due to drugs, osteonecrosis due to previous trauma, other secondary osteonecrosis, other osteonecrosis, and unspecified osteonecrosis. Women seen at departments of oral and maxillofacial surgery, with at least one of the conditions, were classified as potential cases of ONJ. Conditions in anatomic sites other than the jaw were excluded. Validation was performed through medical record review. Case confirmation was based on the ONJ definition by the American Association of Oral and Maxillofacial Surgeons. The algorithm was evaluated by positive predictive values (PPVs) stratified by diagnosis. RESULTS: For the 87 potential cases identified through our algorithm, the medical records were obtained for 83. The overall PPV was 18% (95% confidence interval (CI) 10%–28%). The highest PPV was observed in osteonecrosis due to drugs (83%, 95% CI 36%–100%). Several diagnoses had a PPV of 0 or were not used at all (periapical abscess with sinus, alveolitis of jaws, idiopathic aseptic necrosis of bone, osteonecrosis due to previous trauma, other secondary osteonecrosis, other osteonecrosis, and unspecified osteonecrosis). CONCLUSION: It was possible to ascertain cases of ONJ from the Swedish registers using this algorithm; however, the PPV was low. Thus, further refinements of the algorithm are necessary. Dove Medical Press 2013-01-04 /pmc/articles/PMC3541712/ /pubmed/23323023 http://dx.doi.org/10.2147/CLEP.S37664 Text en © 2013 Bergdahl et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. |
spellingShingle | Original Research Bergdahl, Johan Jarnbring, Fredrik Ehrenstein, Vera Gammelager, Henrik Granath, Fredrik Kieler, Helle Svensson, Madeleine Tell, Grethe S Lagerros, Ylva Trolle Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register |
title | Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register |
title_full | Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register |
title_fullStr | Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register |
title_full_unstemmed | Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register |
title_short | Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register |
title_sort | evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the swedish national patient register |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541712/ https://www.ncbi.nlm.nih.gov/pubmed/23323023 http://dx.doi.org/10.2147/CLEP.S37664 |
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