title: Refining hypertension surveillance to account for potentially misclassified cases.
abstract: Administrative health data have been used in hypertension surveillance using the 1H2P method: the International Classification of Disease (ICD) hypertension diagnosis codes were recorded in at least 1 hospitalization or 2 physician claims within 2 year-period. Accumulation of false positive cases over time using the 1H2P method could result in the overestimation of hypertension prevalence. In this study, we developed and validated a new reclassification method to define hypertension cases using regularized logistic regression with the age, sex, hypertension and comorbidities in physician claims, and diagnosis of hypertension in hospital discharge data as independent variables. A Bayesian method was then used to adjust the prevalence estimated from the reclassification method. We evaluated the hypertension prevalence in data from Alberta, Canada using the currently accepted 1H2P method and these newly developed methods. The reclassification method with Bayesian adjustment produced similar prevalence estimates as the 1H2P method. This supports the continued use of the 1H2P method as a simple and practical way to conduct hypertension surveillance using administrative health data.
authors: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Mingkai
authors: M
authors: Peng
authors: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Guanmin
authors: G
authors: Chen
authors: Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors: Lisa M
authors: LM
authors: Lix
authors: Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors: Finlay A
authors: FA
authors: McAlister
authors: Institute of Clinical Evaluative Sciences and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Karen
authors: K
authors: Tu
authors: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Norm R
authors: NR
authors: Campbell
authors: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Brenda R
authors: BR
authors: Hemmelgarn
authors: Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada.
authors: Lawrence W
authors: LW
authors: Svenson
authors: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Hude
authors: H
authors: Quan
mesh_terms: D000328:Adult; D000416:Alberta / Q000453:epidemiology; D001499:Bayes Theorem; D015897:Comorbidity; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D038801:International Classification of Diseases; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence