title: Canadian administrative health data can identify patients with myasthenia gravis.
abstract: BACKGROUND
  Incidence and prevalence estimates for myasthenia gravis (MG) have varied widely, and the ability of administrative health data (AHD) records to accurately identify cases of MG is yet to be ascertained. The goal of the current study was to validate an algorithm to identify patients with MG in Ontario, Canada using AHD - thereby enabling future disease surveillance.
  
  
  METHODS
  A reference standard population was established using automated key word searching within EMRALD (Electronic Medical Record Administrative data Linked Database) and chart review of potential cases. AHD algorithms were generated and tested against the reference standard. The data was used to calculate MG prevalence rates.
  
  
  RESULTS
  There were 123,997 eligible adult patients, and 49 patients had definite MG (forming the reference standard). An algorithm requiring: (1 hospital discharge abstract with MG listed as a reason for hospitalization or a comorbid condition), or (5 outpatient MG visits and 1 relevant diagnostic test, within 1 year), or (3 pyridostigmine prescriptions, within 1 year) identified MG with sensitivity = 81.6%, specificity = 100%, positive predictive value = 80.0% and negative predictive value = 100%. The population prevalence within our cohort was 0.04%.
  
  
  CONCLUSIONS
  This novel validation method demonstrates the feasibility of using administrative health data to identify patients with myasthenia gravis among the Ontario population.
authors.affiliation: Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ont., Canada.
authors.forename: Ari
authors.initials: A
authors.lastname: Breiner
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Young
authors.forename: Diane
authors.initials: D
authors.lastname: Green
authors.forename: Hans D
authors.initials: HD
authors.lastname: Katzberg
authors.forename: Carolina
authors.initials: C
authors.lastname: Barnett
authors.forename: Vera
authors.initials: V
authors.lastname: Bril
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
mesh_terms: D000328:Adult; D000465:Algorithms; D006801:Humans; D008499:Medical Records; D009157:Myasthenia Gravis / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D062486:Public Health Surveillance / Q000379:methods*