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Stroke surveillance in Manitoba, Canada: estimates from administrative databases
D F Moore1, L M Lix, M S Yogendran
1Walter Reed Army Medical Center, Washington, DC, USA.
Chronic Diseases in Canada
|November 28, 2008
Summary
Population-based administrative databases offer a viable method for stroke surveillance. Despite variations in case numbers across algorithms, stroke prevalence trends remained stable, indicating reliable long-term monitoring capabilities.
Area of Science:
- Public Health
- Epidemiology
- Health Informatics
Background:
- Population-based administrative databases are increasingly utilized for public health surveillance.
- Accurate case ascertainment is crucial for effective disease surveillance, particularly for conditions like stroke.
- Previous studies have explored the utility of administrative data, but comprehensive validation is ongoing.
Purpose of the Study:
- To evaluate the effectiveness of population-based administrative databases for stroke surveillance.
- To develop and apply case-ascertainment algorithms using administrative data for stroke prevalence estimation.
- To assess the stability of stroke prevalence trends over time using different algorithmic approaches.
Main Methods:
- A meta-analysis of four studies was performed to determine the sensitivity and specificity of hospital data for stroke case ascertainment.
- Case-ascertainment algorithms were developed using hospital, physician, and prescription drug records from Manitoba's administrative data.
- Stroke prevalence was estimated for fiscal years 1995/96 to 2003/04, stratified by age, sex, region, and income quintile.
Main Results:
- The meta-analysis indicated over-ascertainment of stroke cases when hospital diagnosis codes for cerebrovascular disease were used (OR: 1.70, 95% CI: 1.53-1.88).
- Analyses of Manitoba administrative data showed substantial variation in the total number of stroke cases identified across different algorithms.
- Despite variations in case counts, the overall trend in stroke prevalence remained stable irrespective of the algorithm employed.
Conclusions:
- Population-based administrative databases can be effectively used for stroke surveillance.
- While the precise number of stroke cases may vary by algorithm, administrative data provide stable prevalence trends for long-term monitoring.
- These findings support the use of administrative data for understanding stroke epidemiology and informing public health strategies.
