TY - JOUR T1 - Determination of the optimal case definition for the diagnosis of end-stage renal disease from administrative claims data in Manitoba, Canada JF - CMAJ Open SP - E264 LP - E269 DO - 10.9778/cmajo.20140006 VL - 3 IS - 3 AU - Paul Komenda AU - Nancy Yu AU - Stella Leung AU - Keevin Bernstein AU - James Blanchard AU - Manish Sood AU - Claudio Rigatto AU - Navdeep Tangri Y1 - 2015/07/17 UR - http://www.cmajopen.ca/content/3/3/E264.abstract N2 - Introduction End-stage renal disease (ESRD) is a major public health problem with increasing prevalence and costs. An understanding of the long-term trends in dialysis rates and outcomes can help inform health policy. We determined the optimal case definition for the diagnosis of ESRD using administrative claims data in the province of Manitoba over a 7-year period.Methods We determined the sensitivity, specificity, predictive value and overall accuracy of 4 administrative case definitions for the diagnosis of ESRD requiring chronic dialysis over different time horizons from Jan. 1, 2004, to Mar. 31, 2011. The Manitoba Renal Program Database served as the gold standard for confirming dialysis status.Results During the study period, 2562 patients were registered as recipients of chronic dialysis in the Manitoba Renal Program Database. Over a 1-year period (2010), the optimal case definition was any 2 claims for outpatient dialysis, and it was 74.6% sensitive (95% confidence interval [CI] 72.3%–76.9%) and 94.4% specific (95% CI 93.6%–95.2%) for the diagnosis of ESRD. In contrast, a case definition of at least 2 claims for dialysis treatment more than 90 days apart was 64.8% sensitive (95% CI 62.2%–67.3%) and 97.1% specific (95% CI 96.5%–97.7%). Extending the period to 5 years greatly improved sensitivity for all case definitions, with minimal change to specificity; for example, for the optimal case definition of any 2 claims for dialysis treatment, sensitivity increased to 86.0% (95% CI 84.7%–87.4%) at 5 years.Conclusion Accurate case definitions for the diagnosis of ESRD requiring dialysis can be derived from administrative claims data. The optimal definition required any 2 claims for outpatient dialysis. Extending the claims period to 5 years greatly improved sensitivity with minimal effects on specificity for all case definitions. ER -