[在常规数据中开发和内部验证糖尿病微血管并发症流行率估计的病例定义]
Lukas Reitzle1, Ingrid Köster2, Oktay Tuncer1
1Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Insitut, Berlin, Germany.
概括
使用医疗保险数据,对糖尿病并发症,如糖尿病视网膜病变 (DRP),糖尿病多神经病变 (DPN) 和糖尿病足综合征 (DFS) 制定准确的病例定义至关重要. 包括额外的ICD代码显著改善了流行率估计,但年度文档是避免低估的关键.
科学领域:
- 公共卫生和流行病学
- 医疗保健服务研究 医疗服务研究
- 糖尿病学 糖尿病学
背景情况:
- 有效的糖尿病监测需要及时获得糖尿病及其微血管并发症的流行数据.
- 法定医疗保险 (SHI) 数据为及时和详细估计糖尿病并发症患病率提供了宝贵的资源.
- 这项研究解决了对验证病例定义的需求,以准确估计糖尿病视网膜病变 (DRP),糖尿病多神经病变 (DPN) 和糖尿病足综合征 (DFS) 的患病率.
研究的目的:
- 开发和内部验证病例定义,以估计DRP,DPN和DFS的流行率.
- 评估包括额外的国际疾病分类 (ICD) 代码在流行率估计上的影响.
- 评估SHI数据中的诊断文档可靠性,以用于监控目的.
主要方法:
- 分析了一大批年龄和性别分层样本 (n=72,744) 的2018年巴默保险公司保险的糖尿病患者.
- 用DRP,DPN和DFS的中央ICD代码构建案例定义,并补充了其他相关的ICD代码.
- 内部验证包括在住院 (m1S) 和门诊 (m2Q) 环境中评估编码,程序代码 (EBM,OPS),药物处方,专家咨询和前一年的文件.
主要成果:
- 基于中央ICD代码的初始流行率为DRP的8.4%,DPN的18.9%,DFS的13.4%.
- 包括额外的ICD代码显著增加了流行率估计,为9.6%的DRP和20.7%的DPN,与DFS (13.5%) 的轻微增加.
- 内部验证证实了高的诊断准确性 (DRP: 96.7%,DPN: 96.5%,DFS: 95.8%),重复的门诊编码 (m2Q) 是最相关的. 考虑到前几年的数据,发现患病率大幅上升,特别是DRP (高达64%以上).
结论:
- 将病例定义扩展到额外的ICD代码增加了糖尿病微血管并发症患病率估计的敏感性.
- 内部验证表明,记录的诊断通常是合理的,支持SHI数据的可靠性.
- 该研究强调,年度文档不是普遍的,这可能导致低估单年横截面分析中的流行率.
相关概念视频
Diabetes: Symptoms, Diagnosis, and Complications
606
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
606
Diabetes Mellitus: Type 2 and Gestational
2.6K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.6K
Data Validation
5.1K
Data validation is an essential part of a comprehensive assessment. Validation is confirming or verifying and opening the door to gathering more assessment data as it clarifies vague or unclear data. The process of checking and verifying the collected information is called data validation. The primary purpose of data validation is to ensure data is as free from error, bias, and misinterpretation as possible.
Nursing assessment guides are generally based on holistic models rather than medical...
Nursing assessment guides are generally based on holistic models rather than medical...
5.1K
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
20
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
20
Pathophysiology of Diabetes
1.0K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
1.0K
Diabetes Mellitus: Overview and Type I Subtype
2.8K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.8K


