Stroke surveillance in Manitoba, Canada: estimates from administrative databases.
This study investigated the use of population-based administrative databases for stroke surveillance. First, a meta-analysis was conducted of four studies, identified via a PubMed search, which estimated the sensitivity and specificity of hospital data for ascertaining cases of stroke when clinical registries or medical charts were the gold standard. Subsequently, case-ascertainment algorithms based on hospital, physician and prescription drug records were developed and applied to Manitoba's administrative data, and prevalence estimates were obtained for fiscal years 1995/96 to 2003/04 by age group, sex, region of residence and income quintile. The meta-analysis results revealed some over-ascertainment of stroke cases from hospital data when the algorithm was based on diagnosis codes for any type of cerebrovascular disease (Mantel-Haenszel Odds-Ratio [OR] - 1.70 [95% confidence interval (CI): 1.53 - 1.88]). Analyses of Manitoba administrative data revealed that while the total number of stroke cases varied substantially across the algorithms, the trend in prevalence was stable regardless of the algorithm adopted.
Moore
D F
DF
Walter Reed Army Medical Center, Washington, DC, USA.
Lix
L M
LM
Yogendran
M S
MS
Martens
P
P
Tamayo
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012042:Registries; D012111:Residence Characteristics; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology*