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Validating a Case Definition for Transgender Adults Using Administrative Data.

Chantal L Rytz1,2, James A King1,3,4, Nathalie Saad5

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Summary
This summary is machine-generated.

This study developed and validated case definitions to identify transgender adults in administrative health data. These definitions, using diagnostic codes and hormone prescriptions, accurately identify transgender populations for health research.

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Area of Science:

  • Health Informatics
  • Epidemiology
  • Transgender Health

Background:

  • Administrative health data are crucial for studying transgender health when self-reported data are unavailable.
  • Developing accurate methods to identify transgender individuals in health records is essential for population-level research.

Purpose of the Study:

  • To develop and validate case definitions for identifying transgender women and men in administrative health data.
  • To compare the accuracy of these definitions against self-reported gender identity.

Main Methods:

  • A cohort study in Alberta, Canada, linked multiple administrative health data sources.
  • Fifteen case definitions were developed and tested for transgender women (9) and transgender men (6).
  • Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Main Results:

  • For transgender women, a definition combining registry identification and hormone prescriptions or diagnostic codes achieved 86.6% sensitivity and 62.5% specificity.
  • For transgender men, a definition combining registry identification and hormone prescriptions or diagnostic codes achieved 78.2% sensitivity and 89.2% specificity.
  • The study included over 5.3 million individuals, with substantial cohorts identified for transgender women and men.

Conclusions:

  • Case definitions incorporating transgender-related diagnostic codes and gender-affirming hormone prescriptions are effective for identifying transgender populations in administrative data.
  • These validated definitions can facilitate research into transgender health, disease burden, and healthcare utilization.
  • This approach enhances the ability to conduct population-level health research for transgender individuals.