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Research

Validity of Canadian discharge abstract data for hypertension and diabetes from 2002 to 2013

Jason Jiang, Danielle Southern, Cynthia A. Beck, Matthew James, Mingshan Lu and Hude Quan
October 28, 2016 4 (4) E646-E653; DOI: https://doi.org/10.9778/cmajo.20160128
Jason Jiang
Departments of Community Health Sciences (Jiang, Southern, Beck, James, Lu, Quan), Psychiatry (Beck), Medicine (James) and Economics (Lu), University of Calgary, Calgary, Alta.
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Danielle Southern
Departments of Community Health Sciences (Jiang, Southern, Beck, James, Lu, Quan), Psychiatry (Beck), Medicine (James) and Economics (Lu), University of Calgary, Calgary, Alta.
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Cynthia A. Beck
Departments of Community Health Sciences (Jiang, Southern, Beck, James, Lu, Quan), Psychiatry (Beck), Medicine (James) and Economics (Lu), University of Calgary, Calgary, Alta.
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Matthew James
Departments of Community Health Sciences (Jiang, Southern, Beck, James, Lu, Quan), Psychiatry (Beck), Medicine (James) and Economics (Lu), University of Calgary, Calgary, Alta.
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Mingshan Lu
Departments of Community Health Sciences (Jiang, Southern, Beck, James, Lu, Quan), Psychiatry (Beck), Medicine (James) and Economics (Lu), University of Calgary, Calgary, Alta.
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Hude Quan
Departments of Community Health Sciences (Jiang, Southern, Beck, James, Lu, Quan), Psychiatry (Beck), Medicine (James) and Economics (Lu), University of Calgary, Calgary, Alta.
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  • Figure 1
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    Figure 1

    Prevalence of hypertension and diabetes in Alberta from 2002 to 2013. APPROACH = Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database, DAD = Canadian hospital Discharge Abstract Database.

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    Figure 2

    Validity of coding for hypertension and diabetes in the Discharge Abstract Database from 2002 to 2013, with the APPROACH database as a reference standard. NPV = negative predictive value, PPV = positive predictive value.

Tables

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    Table 1: Characteristics of patients who underwent coronary artery cauterization in Alberta in 2002 and 2013
    CharacteristicYear; no. (%) of patients*Absolute change between 2002 and 2013
    (95% CI)
    2002
    (n = 4001)
    2013
    (n = 5580)
    Age, mean ± SD, yr63.8 ± 12.362.6 ± 14.8-1.2 (-1.7 to -0.6)
    Men2795 (69.9)3935 (70.5)0.6 (-1.2 to 2.5) 0.6%
    Location
        Calgary1924 (48.1)2300 (41.2)-6.9 (-8.9 to -4.9)
        Edmonton1706 (42.6)2633 (47.2)4.6 (2.5 to 6.6)
    Comorbid conditionAPPROACHDADAPPROACHDADAPPROACHDAD
        Hyperlipidemia2779 (69.4)1912 (47.8)3393 (60.8)660 (11.8)-8.7 (-10.6 to -6.8)-36.0 (-37.7 to -34.2)
        Heart failure456 (11.4)730 (18.2)449 (8.0)985 (17.6)-3.3 (-4.6 to -2.2)-0.6 (-2.2 to 1.0)
        Cerebrovascular disease234 (5.8)150 (3.7)253 (4.5)98 (1.8)-1.3 (-2.2 to -0.4)-2.0 (-2.7 to -1.3)
        Peripheral vascular disease290 (7.2)250 (6.2)159 (2.8)360 (6.4)-4.4 (-5.3 to -3.5)0.2 (-0.8 to 1.2)
    Chronic obstructive pulmonary disease552 (13.8)434 (10.8)800 (14.3)512 (9.2)0.6 (-0.9 to 1.9)-1.7 (-2.9 to -0.4)

    Note: APPROACH = Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database, CI = confidence interval, DAD = Canadian hospital Discharge Abstract Database.

    *Except where noted otherwise.

      • View popup
      Table 2: Change in prevalence of hypertension and diabetes between 2002 and 2013
      Condition; variableYear; prevalence, %Absolute change between 2002 and 2013
      (95% CI)*
      20022013
      APPROACHDADAPPROACHDADAPPROACHDAD
      Hypertension55.854.957.457.81.6 (-0.4 to 3.6)2.9 (0.9 to 4.9)
      Age, yr18-6448.547.349.149.20.6 (-2.2 to 3.4)1.9 (-0.9 to 4.7)
      ≥ 6563.562.967.768.44.2 (1.4 to 7.0)5.6 (2.8 to 8.4)
      SexMale53.553.256.156.72.6 (0.2 to 5.0)3.5 (1.1 to 5.9)
      Female61.158.960.460.4-0.7 (-4.3 to 2.9)1.5 (-2.2 to 5.1)
      CityCalgary54.555.656.456.11.9 (-1.1 to 4.9)0.6 (-2.4 to 3.6)
      Edmonton56.957.455.460.7-1.5 (-4.5 to 1.5)3.2 (0.2 to 6.2)
      Diabetes23.523.923.626.00.1 (-1.6 to 1.8)2.1 (0.4 to 3.9)
      Age, yr18-6419.520.319.622.20.04 (-2.2 to 2.3)1.9 (-0.4 to 4.2)
      ≥ 6527.627.728.630.71.0 (-1.7 to 3.6)3.1 (0.4 to 5.8)
      SexMale22.623.022.825.70.2 (-1.8 to 2.2)2.7 (0.6 to 4.7)
      Female25.426.025.326.80.02 (-3.3 to 3.2)0.9 (-2.4 to 4.1)
      CityCalgary24.024.422.826.4-1.2 (-3.8 to 1.4)2.0 (-0.6 to 4.6)
      Edmonton22.824.023.025.30.2 (-2.4 to 2.7)1.3 (-1.4 to 3.9)

      Note: APPROACH = Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database, CI = confidence interval, DAD = Canadian hospital Discharge Abstract Database.

      *Minor discrepancies are due to rounding.

        • View popup
        Table 3: Validity of coding for hypertension in the Discharge Abstract Database*
        Year; variableSensitivity, %
        (95% CI)
        Specificity, %
        (95% CI)
        Positive predictive value, %
        (95% CI)
        Negative predictive value, %
        (95% CI)
        κ(95% CI)
        200282.2 (79.9-84.5)79.6 (76.9-82.3)83.6 (81.3-85.8)78.0 (75.3-80.7)0.62 (0.59-0.64)
        200374.6 (72.5-76.7)79.8 (77.3-82.3)85.9 (84.1-87.7)65.5 (62.9-68.2)0.52 (0.50-0.54)
        200477.1 (75.1-79.1)78.1 (75.6-80.6)84.4 (82.6-86.3)68.9 (66.3-71.5)0.54 (0.52-0.56)
        200575.5 (73.5-77.6)80.9 (78.4-83.3)87.0 (85.3-88.7)66.1 (63.4-68.7)0.54 (0.52-0.56)
        200679.5 (77.5-81.5)78.8 (76.3-81.3)85.0 (83.2-86.9)71.7 (69.1-74.4)0.57 (0.55-0.60)
        200778.5 (76.4-80.6)71.9 (69.1-74.6)80.5 (78.4-82.5)69.3 (66.5-72.1)0.50 (0.48-0.52)
        200880.0 (77.9-82.0)74.0 (71.3-76.7)81.9 (79.9-83.9)71.5 (68.7-74.3)0.54 (0.51-0.56)
        200979.3 (77.2-81.4)74.5 (71.7-77.2)81.9 (79.9-84.0)71.1 (68.3-73.8)0.53 (0.51-0.56)
        201081.8 (79.8-83.7)72.1 (69.3-74.8)81.2 (79.2-83.1)72.9 (70.1-75.6)0.54 (0.52-0.56)
        201180.8 (78.8-82.9)71.2 (68.4-73.9)79.4 (77.3-81.4)73.0 (70.3-75.7)0.52 (0.50-0.55)
        201282.5 (80.6-84.4)71.0 (68.3-73.7)79.8 (77.8-81.7)74.5 (71.9-77.1)0.54 (0.52-0.56)
        201379.8 (77.8-81.8)71.9 (69.3-74.5)79.3 (77.3-81.3)72.5 (70.0-75.1)0.52 (0.49-0.54)
        Age, yr18-6476.9 (73.9-79.9)77.6 (74.6-80.5)76.8 (73.8-79.8)77.7 (74.7-80.6)0.54 (0.52-0.57)
        ≥ 6582.4 (79.8-85.0)60.8 (56.0-65.7)81.5 (78.8-84.1)62.3 (57.4-67.1)0.43 (0.40-0.47)
        SexMale79.2 (76.8-81.6)72.1 (69.1-75.2)78.4 (76.0-80.9)73.1 (70.1-76.1)0.51 (0.49-0.54)
        Female81.1 (77.6-84.6)71.3 (66.3-76.3)81.2 (77.7-84.6)71.2 (66.2-76.1)0.52 (0.48-0.57)
        CityCalgary76.3 (73.0-79.7)70.1 (66.0-74.1)76.8 (73.5-80.1)69.6 (65.5-73.6)0.46 (0.43-0.50)
        Edmonton86.5 (84.0-89.0)71.5 (67.8-75.2)79.0 (76.2-81.9)81.0 (77.6-84.4)0.59 (0.55-0.62)

        Note: CI = confidence interval.

        *With the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database as the reference standard.

          • View popup
          Table 4: Validity of coding for diabetes in the Discharge Abstract Database*
          Year; variableSensitivity, % (95% CI)Specificity, % (95% CI)Positive predictive value, % (95% CI)Negative predictive value, % (95% CI)κ (95% CI)
          200292.1 (89.7-94.6)97.0 (96.2-97.9)90.5 (87.8-93.1)97.6 (96.8-98.4)0.89 (0.87-0.90)
          200389.6 (87.2-92.0)96.3 (95.5-97.2)88.2 (85.6-90.7)96.8 (96.0-97.6)0.85 (0.84-0.87)
          200483.8 (80.8-86.7)96.7 (95.9-97.4)87.5 (84.7-90.2)95.5 (94.7-96.4)0.82 (0.80-0.84)
          200581.5 (78.5-84.5)96.6 (95.8-97.4)87.9 (85.3-90.6)94.5 (93.5-95.4)0.80 (0.78-0.82)
          200688.9 (86.4-91.5)96.6 (95.8-97.4)88.1 (85.5-90.7)96.8 (96.1-97.6)0.85 (0.84-0.87)
          200791.1 (88.8-93.5)95.4 (94.4-96.3)85.6 (82.9-88.4)97.3 (96.5-98.0)0.85 (0.83-0.86)
          200890.8 (88.4-93.3)95.5 (94.6-96.5)85.2 (82.3-88.1)97.4 (96.6-98.1)0.84 (0.83-0.86)
          200990.7 (88.3-93.1)95.0 (94.0-96.0)84.6 (81.8-87.5)97.1 (96.3-97.9)0.84 (0.82-0.85)
          201091.8 (89.5-94.0)95.4 (94.5-96.4)85.3 (82.5-88.1)97.6 (96.9-98.3)0.85 (0.83-0.87)
          201191.4 (89.1-93.7)93.9 (92.9-95.0)81.5 (78.5-84.5)97.4 (96.7-98.1)0.82 (0.80-0.84)
          201291.6 (89.4-93.8)93.9 (92.9-95.0)81.4 (78.5-84.3)97.5 (96.8-98.2)0.82 (0.80-0.84)
          201390.7 (88.5-93.0)94.0 (93.0-95.0)82.3 (79.5-85.1)97.0 (96.3-97.8)0.82 (0.80-0.84)
          Age, yr18-6489.4 (85.9-92.9)94.2 (92.9-95.5)78.9 (74.5-83.3)97.3 (96.4-98.3)0.80 (0.77-0.82)
          ≥ 6591.8 (88.9-94.7)93.7 (92.1-95.3)85.3 (81.8-88.9)96.6 (95.4-97.8)0.84 (0.81-0.86)
          SexMale91.8 (89.2-94.3)93.9 (92.7-95.1)81.7 (78.3-85.1)97.5 (96.7-98.3)0.82 (0.80-0.84)
          Female88.5 (84.1-92.9)94.1 (92.3-96.0)83.7 (78.7-88.6)96.0 (94.4-97.6)0.81 (0.78-0.84)
          CityCalgary91.6 (88.2-95.0)92.8 (91.1-94.6)79.1 (74.5-83.7)97.4 (96.3-98.5)0.80 (0.77-0.83)
          Edmonton91.7 (88.6-94.9)94.5 (93.1-95.9)83.3 (79.3-87.4)97.5 (96.5-98.5)0.83 (0.81-0.86)

          Note: CI = confidence interval.

          *With the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database as the reference standard.

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          Validity of Canadian discharge abstract data for hypertension and diabetes from 2002 to 2013
          Jason Jiang, Danielle Southern, Cynthia A. Beck, Matthew James, Mingshan Lu, Hude Quan
          Oct 2016, 4 (4) E646-E653; DOI: 10.9778/cmajo.20160128

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          Validity of Canadian discharge abstract data for hypertension and diabetes from 2002 to 2013
          Jason Jiang, Danielle Southern, Cynthia A. Beck, Matthew James, Mingshan Lu, Hude Quan
          Oct 2016, 4 (4) E646-E653; DOI: 10.9778/cmajo.20160128
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