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Performance of administrative case definitions for comorbidity in multiple sclerosis in Manitoba and Nova Scotia
R A Marrie1, J D Fisk2, K J Stadnyk3
1Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Introduction:
As the population ages and the prevalence of comorbid conditions increases, the need for feasible, validated methods of comorbidity surveillance in chronic diseases such as multiple sclerosis (MS) increases.
Methods:
Using kappa (k) statistics, we evaluated the performance of administrative case definitions for comorbidities commonly observed in MS by comparing agreement between Manitoba (MB) administrative data and self-report (n = 606) and Nova Scotia (NS) administrative data and self-report (n = 1923).
Results:
Agreement between the administrative definitions and self-report was substantial for hypertension (k = 0.69 [NS], 0.76 [MB]) and diabetes (k = 0.70 [NS], 0.66 [MB]); moderate for hyperlipidemia (k = 0.53 [NS], 0.51 [MB]) and heart disease (k = 0.42 [NS], 0.51 [MB]) and fair for anxiety (k = 0.27 [NS], 0.26 [MB]). In NS, agreement was substantial for inflammatory bowel disease (k = 0.71) and moderate for epilepsy (k = 0.48).
Conclusion:
Administrative definitions for commonly observed comorbidities in MS performed well in 2 distinct jurisdictions. This suggests that they could be used more broadly across Canada and in national studies.
Insights
Administrative data accurately identify common multiple sclerosis (MS) comorbidities. These validated methods offer feasible comorbidity surveillance for chronic disease management across Canada.
Area of Science:
- Medical informatics
- Epidemiology
- Chronic disease management
Background:
- Aging populations and increasing comorbidities necessitate validated surveillance methods for chronic diseases like multiple sclerosis (MS).
- Feasible and reliable comorbidity surveillance is crucial for effective chronic disease management.
Purpose of the Study:
- To evaluate the performance of administrative case definitions for comorbidities in multiple sclerosis (MS).
- To compare the agreement between administrative data and self-report for common MS comorbidities across two Canadian provinces.
Main Methods:
- Kappa (k) statistics were used to assess agreement between administrative data and self-reported comorbidities.
- Data from Manitoba (MB) and Nova Scotia (NS) were analyzed, comparing administrative case definitions with self-report data from 606 (MB) and 1923 (NS) participants.
Main Results:
- Substantial agreement was found for hypertension and diabetes between administrative data and self-report.
- Moderate agreement was observed for hyperlipidemia and heart disease, while fair agreement was noted for anxiety.
- In Nova Scotia, substantial agreement was found for inflammatory bowel disease and moderate agreement for epilepsy.
Conclusions:
- Administrative case definitions for common MS comorbidities demonstrate good performance in distinct Canadian jurisdictions.
- These validated administrative definitions are suitable for broader use in Canadian and national studies for comorbidity surveillance.
- The findings support the use of administrative data for efficient and reliable monitoring of comorbidities in multiple sclerosis populations.
