title: Occurrence of inflammatory bowel disease in central Italy: a study based on health information systems.
abstract: BACKGROUND
  The burden of inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, has never been estimated in Italy using administrative data sources. Our objective was to measure the occurrence of inflammatory bowel diseases in the Lazio region (Italy) using administrative data and to test the sensitivity of the Crohn's disease case-finding algorithm with respect to clinical diagnosis.
  
  
  METHODS
  We conducted a population-based cross-sectional study identifying prevalent and incident cases. We estimated occurrence rates of inflammatory bowel diseases using hospital discharges or activation of copayment exemptions. Sensitivity was calculated from 2358 subjects with clinical diagnosis of Crohn's disease.
  
  
  RESULTS
  Exemptions identified more than 20% of the cases. Prevalence rates (per 100,000) on December 31, 2009 for males and females were 177 and 144 for ulcerative colitis and 91 and 81 for Crohn's disease, respectively. The incidence rates during the years 2008-2009 were 14.5 and 12.2 for ulcerative colitis and 7.4 and 6.5 for Crohn's disease for males and females, respectively. The sensitivity of the administrative sources was 82.2%.
  
  
  CONCLUSIONS
  Health and population data sources allow the estimation of inflammatory bowel diseases occurrence. The age-specific peaks of diagnosis were consistent with those reported in other studies. Sensitivity may be affected by temporal changes in the quality of the data sources.
authors.affiliation: Department of Epidemiology, Regional Health Service, Rome, Italy. Electronic address: r.didomenicantonio@deplazio.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Di Domenicantonio
authors.affiliation: Department of Epidemiology, Regional Health Service, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cappai
authors.affiliation: Department of Epidemiology, Regional Health Service, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Arcà
authors.affiliation: Department of Epidemiology, Regional Health Service, Rome, Italy.
authors.forename: Nera
authors.initials: N
authors.lastname: Agabiti
authors.affiliation: Division of Gastroenterology, AO San Camillo Forlanini, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Kohn
authors.affiliation: Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome, Rome, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Vernia
authors.affiliation: Department of Internal Medicine, Gastroenterology Unit, University Tor Vergata, Rome, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
authors.affiliation: IBD Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Armuzzi
authors.affiliation: Division of Gastroenterology, AO San Filippo Neri, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Papi
authors.affiliation: Department of Epidemiology, Regional Health Service, Rome, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Davoli
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D063005:Health Information Systems; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012372:ROC Curve; D012189:Retrospective Studies; D017678:Sex Distribution; D055815:Young Adult
keywords: Accuracy; Crohn's disease; Epidemiology; Health information system; Ulcerative colitis