Case definitions for chronic rhinosinusitis in administrative data: A systematic review

Area of Science:

• Epidemiology
• Pharmacology
• Health Informatics

Background:

• Administrative data, including electronic health records, are increasingly utilized in pharmacoepidemiologic research for chronic rhinosinusitis (CRS).
• While offering large sample sizes and accessibility, the use of administrative data poses a risk of inaccurate cohort identification, potentially biasing research outcomes.
• Accurate case definitions are critical for reliable pharmacoepidemiologic studies using administrative health data.

Purpose of the Study:

• To systematically review and report current case definitions for chronic rhinosinusitis (CRS) employed in administrative database research.
• To identify and define the various administrative databases that have been used for CRS research.

Main Methods:

• A systematic literature search was conducted across medical databases up to February 1, 2015.
• Studies were included if they utilized health records databases for CRS-specific data and reported International Classification of Disease (ICD) codes.
• Exclusion criteria included non-CRS cohorts, failure to use or report ICD codes, and non-peer-reviewed publications.

Main Results:

• The review identified 27 studies, evaluating 13 different administrative databases and 8 distinct CRS case definitions.
• Only one of the eight identified CRS case definitions was validated.
• The most frequently used case definition for CRS in administrative data was the ICD-9 473.x code.

Conclusions:

• The accuracy of pharmacoepidemiologic research on CRS using administrative data hinges on the application of appropriate case definitions.
• A significant number of nonvalidated CRS case definitions are currently in use within administrative database research.
• There is a critical need for the development of a generalizable and validated ICD-based CRS case definition to enhance the precision of future research.