Validation of Algorithm to Identify Persons with Non-traumatic Spinal Cord Dysfunction in Canada Using Administrative Health Data.

Background: Administrative health data, such as the hospital Discharge Abstract Database (DAD), can potentially be used to identify patients with non-traumatic spinal cord dysfunction (NTSCD). Algorithms utilizing administrative health data for this purpose should be validated before clinical use. O...

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Published in:Topics in Spinal Cord Injury Rehabilitation Vol. 23; no. 4; pp. 333 - 343
Main Authors: Ho, Chester, Guilcher, Sara J. T., McKenzie, Nicole, Mouneimne, Magda, Williams, Anita, Voth, Jennifer, Yan Chen, Cronin, Shawna, Noonan, Vanessa K., Jaglal, Susan B.
Format: algorithm research tables/charts Journal Article
Published: KnowledgeWorks Global, Ltd Fall2017
Online Access:View this record in EBSCOhost
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      dt: Fall2017
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      pub: KnowledgeWorks Global, Ltd
      place: Richmond, Virginia
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        10.1310/sci2304-333
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        atl: Validation of Algorithm to Identify Persons with Non-traumatic Spinal Cord Dysfunction in Canada Using Administrative Health Data.
      aug:
        au:
          Ho, Chester
          Guilcher, Sara J. T.
          McKenzie, Nicole
          Mouneimne, Magda
          Williams, Anita
          Voth, Jennifer
          Yan Chen
          Cronin, Shawna
          Noonan, Vanessa K.
          Jaglal, Susan B.
        affil: Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
      sug:
        subj:
          Spinal Cord Diseases Diagnosis
          Algorithms Evaluation
          Resource Databases, Health
          Alberta
          International Classification of Diseases
          Retrospective Design
          Validation Studies
          Record Review
          Sensitivity and Specificity
          Predictive Value of Tests
          Confidence Intervals
          Human
          Funding Source
      ab: Background: Administrative health data, such as the hospital Discharge Abstract Database (DAD), can potentially be used to identify patients with non-traumatic spinal cord dysfunction (NTSCD). Algorithms utilizing administrative health data for this purpose should be validated before clinical use. Objective: To validate an algorithm designed to identify patients with NTSCD through DAD. Method: DAD between 2006 and 2016 for Southern Alberta in Canada were obtained through Alberta Health Services. Cases of NTSCD were identified using the algorithm designed by the research team. These were then validated by chart review using electronic medical records where possible and paper records where electronic records were unavailable. Measures of diagnostic accuracy including sensitivity, specificity, and positive and negative predictive values and 95% confidence intervals (CI) were computed. Results: Two hundred and eighty cases were identified to have both the administrative codes for neurological impairments and NTSCD etiology. Twenty-eight cases were excluded from analysis as 5 had inadequate medical record information, 17 had traumatic spinal cord injury, and 6 were considered "other" non-spinal cord conditions. Measures of diagnostic accuracy that were computed were sensitivity 97% (95% CI, 94%-98%), specificity 60% (95% CI, 47%-73%), positive predictive value (PPV) 92% (95% CI, 88%-95%), and negative predictive value (NPV) 80% (95% CI, 65%-90%). The most prevalent etiologies were degenerative (36.9%), infection (19.0%), oncology malignant (15.1%), and vascular (10.3%). Conclusion: Our algorithm has high sensitivity and PPV and satisfactory specificity and NPV for the identification of persons with NTSCD using DAD, though the limitations for using this method should be recognized.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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