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Scleroderma prevalence: demographic variations in a population-based sample.
Arthritis Rheum 2009; 61(3):400-4AR

Abstract

OBJECTIVE

To estimate the prevalence of systemic sclerosis (SSc) using population-based administrative data, and to assess the sensitivity of case ascertainment approaches.

METHODS

We ascertained SSc cases from Quebec physician billing and hospitalization databases (covering approximately 7.5 million individuals). Three case definition algorithms were compared, and statistical methods accounting for imperfect case ascertainment were used to estimate SSc prevalence and case ascertainment sensitivity. A hierarchical Bayesian latent class regression model that accounted for possible between-test dependence conditional on disease status estimated the effect of patient characteristics on SSc prevalence and the sensitivity of the 3 ascertainment algorithms.

RESULTS

Accounting for error inherent in both the billing and the hospitalization data, we estimated SSc prevalence in 2003 at 74.4 cases per 100,000 women (95% credible interval [95% CrI] 69.3-79.7) and 13.3 cases per 100,000 men (95% CrI 11.1-16.1). Prevalence was higher for older individuals, particularly in urban women (161.2 cases per 100,000, 95% CrI 148.6-175.0). Prevalence was lowest in young men (in rural areas, as low as 2.8 cases per 100,000, 95% CrI 1.4-4.8). In general, no single algorithm was very sensitive, with point estimates for sensitivity ranging from 20-73%.

CONCLUSION

We found marked differences in SSc prevalence according to age, sex, and region. In general, no single case ascertainment approach was very sensitive for SSc. Therefore, using data from multiple sources, with adjustment for the imperfect nature of each, is an important strategy in population-based studies of SSc and similar conditions.

Authors+Show Affiliations

Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada. sasha.bernatsky@mail.mcgill.ca

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19248123

Citation

Bernatsky, S, et al. "Scleroderma Prevalence: Demographic Variations in a Population-based Sample." Arthritis and Rheumatism, vol. 61, no. 3, 2009, pp. 400-4.
Bernatsky S, Joseph L, Pineau CA, et al. Scleroderma prevalence: demographic variations in a population-based sample. Arthritis Rheum. 2009;61(3):400-4.
Bernatsky, S., Joseph, L., Pineau, C. A., Belisle, P., Hudson, M., & Clarke, A. E. (2009). Scleroderma prevalence: demographic variations in a population-based sample. Arthritis and Rheumatism, 61(3), pp. 400-4. doi:10.1002/art.24339.
Bernatsky S, et al. Scleroderma Prevalence: Demographic Variations in a Population-based Sample. Arthritis Rheum. 2009 Mar 15;61(3):400-4. PubMed PMID: 19248123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scleroderma prevalence: demographic variations in a population-based sample. AU - Bernatsky,S, AU - Joseph,L, AU - Pineau,C A, AU - Belisle,P, AU - Hudson,M, AU - Clarke,A E, PY - 2009/2/28/entrez PY - 2009/2/28/pubmed PY - 2009/5/27/medline SP - 400 EP - 4 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 61 IS - 3 N2 - OBJECTIVE: To estimate the prevalence of systemic sclerosis (SSc) using population-based administrative data, and to assess the sensitivity of case ascertainment approaches. METHODS: We ascertained SSc cases from Quebec physician billing and hospitalization databases (covering approximately 7.5 million individuals). Three case definition algorithms were compared, and statistical methods accounting for imperfect case ascertainment were used to estimate SSc prevalence and case ascertainment sensitivity. A hierarchical Bayesian latent class regression model that accounted for possible between-test dependence conditional on disease status estimated the effect of patient characteristics on SSc prevalence and the sensitivity of the 3 ascertainment algorithms. RESULTS: Accounting for error inherent in both the billing and the hospitalization data, we estimated SSc prevalence in 2003 at 74.4 cases per 100,000 women (95% credible interval [95% CrI] 69.3-79.7) and 13.3 cases per 100,000 men (95% CrI 11.1-16.1). Prevalence was higher for older individuals, particularly in urban women (161.2 cases per 100,000, 95% CrI 148.6-175.0). Prevalence was lowest in young men (in rural areas, as low as 2.8 cases per 100,000, 95% CrI 1.4-4.8). In general, no single algorithm was very sensitive, with point estimates for sensitivity ranging from 20-73%. CONCLUSION: We found marked differences in SSc prevalence according to age, sex, and region. In general, no single case ascertainment approach was very sensitive for SSc. Therefore, using data from multiple sources, with adjustment for the imperfect nature of each, is an important strategy in population-based studies of SSc and similar conditions. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/19248123/Scleroderma_prevalence:_demographic_variations_in_a_population_based_sample_ L2 - https://doi.org/10.1002/art.24339 DB - PRIME DP - Unbound Medicine ER -