Accuracy and Sensitivity of Parkinsonian Disorder Diagnoses in Two Swedish National Health Registers

Background: Swedish population-based national health registers are widely used data sources in epidemiological research. Register-based diagnoses of Parkinson’s disease have not been validated against clinical information. Methods: Parkinson’s disease (PD) and other parkinsonian disorder diagnoses w...

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Veröffentlicht in:Neuroepidemiology 2012-01, Vol.38 (3), p.186-193
Hauptverfasser: Feldman, Adina L., Johansson, Anna L.V., Gatz, Margaret, Flensburg, Måns, Petzinger, Giselle M., Widner, Håkan, Lew, Mark F., Pedersen, Nancy L., Wirdefeldt, Karin
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container_end_page 193
container_issue 3
container_start_page 186
container_title Neuroepidemiology
container_volume 38
creator Feldman, Adina L.
Johansson, Anna L.V.
Gatz, Margaret
Flensburg, Måns
Petzinger, Giselle M.
Widner, Håkan
Lew, Mark F.
Pedersen, Nancy L.
Wirdefeldt, Karin
description Background: Swedish population-based national health registers are widely used data sources in epidemiological research. Register-based diagnoses of Parkinson’s disease have not been validated against clinical information. Methods: Parkinson’s disease (PD) and other parkinsonian disorder diagnoses were ascertained in two registers, i.e. the National Patient Register (NPR) and the Cause of Death Register (CDR). Diagnoses were validated in terms of accuracy (positive predictive value) and sensitivity against data from a population-based study of PD in 1998–2004 that screened more than 35,000 persons and identified 194 cases of parkinsonian disorders including 132 PD cases (the gold standard for the purposes of this study). Results: Accuracy for any parkinsonian disorder diagnoses was 88.0% in the NPR and 94.4% in the CDR. Accuracy of PD diagnoses was 70.8% in the NPR and 66.7% in the CDR. Misclassification between differential parkinsonian diagnoses was common. The accuracy of PD diagnoses in the NPR improved to 83.0% by restricting the definition to primary diagnoses only. The sensitivity of PD diagnoses in the NPR and CDR combined was 83.1%, with a mean time to detection of 6.9 years. Conclusions: Population-based national health registers are valid data sources in epidemiological studies of PD or parkinsonian disorder etiology but are less suitable in studies of incidence or prevalence.
doi_str_mv 10.1159/000336356
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Register-based diagnoses of Parkinson’s disease have not been validated against clinical information. Methods: Parkinson’s disease (PD) and other parkinsonian disorder diagnoses were ascertained in two registers, i.e. the National Patient Register (NPR) and the Cause of Death Register (CDR). Diagnoses were validated in terms of accuracy (positive predictive value) and sensitivity against data from a population-based study of PD in 1998–2004 that screened more than 35,000 persons and identified 194 cases of parkinsonian disorders including 132 PD cases (the gold standard for the purposes of this study). Results: Accuracy for any parkinsonian disorder diagnoses was 88.0% in the NPR and 94.4% in the CDR. Accuracy of PD diagnoses was 70.8% in the NPR and 66.7% in the CDR. Misclassification between differential parkinsonian diagnoses was common. The accuracy of PD diagnoses in the NPR improved to 83.0% by restricting the definition to primary diagnoses only. The sensitivity of PD diagnoses in the NPR and CDR combined was 83.1%, with a mean time to detection of 6.9 years. Conclusions: Population-based national health registers are valid data sources in epidemiological studies of PD or parkinsonian disorder etiology but are less suitable in studies of incidence or prevalence.</description><identifier>ISSN: 0251-5350</identifier><identifier>ISSN: 1423-0208</identifier><identifier>EISSN: 1423-0208</identifier><identifier>DOI: 10.1159/000336356</identifier><identifier>PMID: 22472568</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Aged ; Aged, 80 and over ; Cause of Death ; Clinical Medicine ; Diagnostic Errors - statistics &amp; numerical data ; Diseases in Twins - diagnosis ; Diseases in Twins - epidemiology ; Epidemiological methods ; Female ; Humans ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Methods in Neuroepidemiology ; Neurologi ; Neurology ; Parkinson disease ; Parkinsonian disorders ; Parkinsonian Disorders - diagnosis ; Parkinsonian Disorders - epidemiology ; Predictive Value of Tests ; Registries ; Sensitivity and Specificity ; Sweden - epidemiology ; Validation studies</subject><ispartof>Neuroepidemiology, 2012-01, Vol.38 (3), p.186-193</ispartof><rights>2012 S. Karger AG, Basel</rights><rights>Copyright © 2012 S. Karger AG, Basel.</rights><rights>Copyright (c) 2012 S. Karger AG, Basel</rights><rights>Copyright © 2012 by S. 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Register-based diagnoses of Parkinson’s disease have not been validated against clinical information. Methods: Parkinson’s disease (PD) and other parkinsonian disorder diagnoses were ascertained in two registers, i.e. the National Patient Register (NPR) and the Cause of Death Register (CDR). Diagnoses were validated in terms of accuracy (positive predictive value) and sensitivity against data from a population-based study of PD in 1998–2004 that screened more than 35,000 persons and identified 194 cases of parkinsonian disorders including 132 PD cases (the gold standard for the purposes of this study). Results: Accuracy for any parkinsonian disorder diagnoses was 88.0% in the NPR and 94.4% in the CDR. Accuracy of PD diagnoses was 70.8% in the NPR and 66.7% in the CDR. Misclassification between differential parkinsonian diagnoses was common. The accuracy of PD diagnoses in the NPR improved to 83.0% by restricting the definition to primary diagnoses only. The sensitivity of PD diagnoses in the NPR and CDR combined was 83.1%, with a mean time to detection of 6.9 years. 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Register-based diagnoses of Parkinson’s disease have not been validated against clinical information. Methods: Parkinson’s disease (PD) and other parkinsonian disorder diagnoses were ascertained in two registers, i.e. the National Patient Register (NPR) and the Cause of Death Register (CDR). Diagnoses were validated in terms of accuracy (positive predictive value) and sensitivity against data from a population-based study of PD in 1998–2004 that screened more than 35,000 persons and identified 194 cases of parkinsonian disorders including 132 PD cases (the gold standard for the purposes of this study). Results: Accuracy for any parkinsonian disorder diagnoses was 88.0% in the NPR and 94.4% in the CDR. Accuracy of PD diagnoses was 70.8% in the NPR and 66.7% in the CDR. Misclassification between differential parkinsonian diagnoses was common. The accuracy of PD diagnoses in the NPR improved to 83.0% by restricting the definition to primary diagnoses only. The sensitivity of PD diagnoses in the NPR and CDR combined was 83.1%, with a mean time to detection of 6.9 years. Conclusions: Population-based national health registers are valid data sources in epidemiological studies of PD or parkinsonian disorder etiology but are less suitable in studies of incidence or prevalence.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>22472568</pmid><doi>10.1159/000336356</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
Cause of Death
Clinical Medicine
Diagnostic Errors - statistics & numerical data
Diseases in Twins - diagnosis
Diseases in Twins - epidemiology
Epidemiological methods
Female
Humans
Klinisk medicin
Male
Medical and Health Sciences
Medicin och hälsovetenskap
Methods in Neuroepidemiology
Neurologi
Neurology
Parkinson disease
Parkinsonian disorders
Parkinsonian Disorders - diagnosis
Parkinsonian Disorders - epidemiology
Predictive Value of Tests
Registries
Sensitivity and Specificity
Sweden - epidemiology
Validation studies
title Accuracy and Sensitivity of Parkinsonian Disorder Diagnoses in Two Swedish National Health Registers
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