Dataset Information

Inaccurate ascertainment of morbidity and mortality due to influenza in administrative databases: a population-based record linkage study.

ABSTRACT:

Background

Historically, counting influenza recorded in administrative health outcome databases has been considered insufficient to estimate influenza attributable morbidity and mortality in populations. We used database record linkage to evaluate whether modern databases have similar limitations.

Methods

Person-level records were linked across databases of laboratory notified influenza, emergency department (ED) presentations, hospital admissions and death registrations, from the population (?6.9 million) of New South Wales (NSW), Australia, 2005 to 2008.

Results

There were 2568 virologically diagnosed influenza infections notified. Among those, 25% of 40 who died, 49% of 1451 with a hospital admission and 7% of 1742 with an ED presentation had influenza recorded on the respective database record. Compared with persons aged ?65 years and residents of regional and remote areas, respectively, children and residents of major cities were more likely to have influenza coded on their admission record. Compared with older persons and admitted patients, respectively, working age persons and non-admitted persons were more likely to have influenza coded on their ED record. On both ED and admission records, persons with influenza type A infection were more likely than those with type B infection to have influenza coded. Among death registrations, hospital admissions and ED presentations with influenza recorded as a cause of illness, 15%, 28% and 1.4%, respectively, also had laboratory notified influenza. Time trends in counts of influenza recorded on the ED, admission and death databases reflected the trend in counts of virologically diagnosed influenza.

Conclusions

A minority of the death, hospital admission and ED records for persons with a virologically diagnosed influenza infection identified influenza as a cause of illness. Few database records with influenza recorded as a cause had laboratory confirmation. The databases have limited value for estimating incidence of influenza outcomes, but can be used for monitoring variation in incidence over time.

SUBMITTER: Muscatello DJ

PROVIDER: S-EPMC4038604 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Inaccurate ascertainment of morbidity and mortality due to influenza in administrative databases: a population-based record linkage study.

Muscatello David J DJ Amin Janaki J MacIntyre C Raina CR Newall Anthony T AT Rawlinson William D WD Sintchenko Vitali V Gilmour Robin R Thackway Sarah S

PloS one 20140529 5

<h4>Background</h4>Historically, counting influenza recorded in administrative health outcome databases has been considered insufficient to estimate influenza attributable morbidity and mortality in populations. We used database record linkage to evaluate whether modern databases have similar limitations.<h4>Methods</h4>Person-level records were linked across databases of laboratory notified influenza, emergency department (ED) presentations, hospital admissions and death registrations, from the ...[more]

PMID: 24875306

Similar Datasets

Project description:ObjectiveThese analyses aim to comparatively evaluate the persistence on treatment of different biological disease-modifying antirheumatic drugs (bDMARDs) when administered in monotherapy compared with combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) in rheumatoid arthritis (RA) patients receiving first-line biologics.DesignThis is a retrospective observational study on Administrative Healthcare Databases.MethodsData were extracted from healthcare databases of the Lombardy Region, Italy (2004-2013), as a part of the RECord-linkage On Rheumatic Diseases study, on behalf of the Italian Society for Rheumatology. Analyses included patients with RA starting first-line approved course of bDMARDs and evaluated drug survival by using Cox proportional hazard models. Results are presented as HRs and 95% CI, crude and adjusted for prespecified confounders (age, sex, disease duration, Charlson Comorbidity Index (CCI), previous infections, use of concomitant glucocorticoids or non-steroidal anti-inflammatory drugs (NSAIDs)).Results4478 patients with RA were included (17.84% monotherapy). Etanercept, adalimumab and infliximab were the most prescribed first-line biologics. bDMARD monotherapy was associated with longer disease duration, higher CCI, lower glucocorticoids and NSAIDs use. Compared with monotherapy, combination associated with a lower risk of failure (adjusted HR 0.79, 95% CI 0.72 to 0.88). Among monotherapies, considering etanercept as reference, adalimumab (1.28, 95% CI 1.03 to 1.59) and infliximab (2.41, 95% CI 1.85 to 3.15) had higher risk of failure. Concomitant methotrexate (0.78, 95% CI 0.70 to 0.87), leflunomide (0.80, 95% CI 0.65 to 0.98) or csDMARD combinations (0.77, 95% CI 0.68 to 0.87) reduced the risk of bDMARD withdrawal.ConclusionAdalimumab and infliximab monotherapies show lower retention rate compared with etanercept. The relatively small number of therapeutic courses different from tumour necrosis factor (TNF) inhibitors makes more difficult to achieve conclusive results with other biologics. Concomitant methotrexate, leflunomide and csDMARDs combination associate with longer survival on bDMARD. Our data confirm the effectiveness of the current practices in the choice of etanercept as first-line anti-TNF monotherapy and strengthen the currently recommended use of bDMARDs in combination with csDMARDs.

Project description:IntroductionThe aims of this program of research are to use linked health and law enforcement data to describe individuals presenting to emergency and inpatient healthcare services with an acute alcohol harm or problematic alcohol use; measure their health service utilisation and law enforcement engagement; and quantify morbidity, mortality, offending and incarceration.Methods and analysisWe will assemble a retrospective cohort of people presenting to emergency departments and/or admitted to hospitals between 1 January 2005 and 31 December 2014 in New South Wales, Australia with a diagnosis denoting an acute alcohol harm or problematic alcohol use. We will link these data with records from other healthcare services (eg, community-based mental healthcare data, cancer registry), mortality, offending and incarceration data sets. The four overarching areas for analysis comprise: (1) describing the characteristics of the cohort at their first point of contact with emergency and inpatient hospital services in the study period with a diagnosis indicating an acute alcohol harm and/or problematic alcohol use; (2) quantifying health service utilisation and law enforcement engagement; (3) quantifying rates of mortality, morbidity, offending and incarceration; and (4) assessing predictors (eg, age, sex) of mortality, morbidity, offending and incarceration among this cohort.Ethics and disseminationEthics approval has been provided by the New South Wales Population and Health Services Research Ethics Committee. We will report our findings in accordance with the REporting of studies Conducted using Observational Routinely collected health Data (RECORD) statement and Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) where appropriate. We will publish data in tabular, aggregate forms only. We will not disclose individual results. We will disseminate project findings at scientific conferences and in peer-reviewed journals. We will aim to present findings to relevant stakeholders (eg, addiction medicine and emergency medicine specialists, policy makers) to maximise translational impact of research findings.

Dataset Information

Inaccurate ascertainment of morbidity and mortality due to influenza in administrative databases: a population-based record linkage study.

Background

Methods

Results

Conclusions

Publications

Inaccurate ascertainment of morbidity and mortality due to influenza in administrative databases: a population-based record linkage study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets