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Validation of asthma and eczema in population-based Swedish drug and patient registers
Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden..
Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden..ORCID iD: 0000-0002-6546-3650
Karolinska Inst, Dept Med, Ctr Pharmacoepidemiol, SE-17177 Stockholm, Sweden.;Stockholm Cty Council, Publ Healthcare Serv Comm Adm, Stockholm, Sweden..
Orebro University Hospital. Orebro Univ Hosp, Dept Pediat, Orebro, Sweden.;Karolinska Inst, Dept Med, Clin Epidemiol Unit, SE-17177 Stockholm, Sweden..ORCID iD: 0000-0003-1024-5602
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2013 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 22, no 8, 850-860 p.Article in journal (Refereed) Published
Abstract [en]

Purpose Validated measures of asthma and eczema at the population level remain a challenge. Our aim was to ascertain if register-based information on asthma/eczema medication can function as a proxy for an asthma/eczema diagnosis and to validate register-based asthma diagnoses. Methods Information was requested on all 0-45-year-old individuals with reported asthma/eczema medication and/or diagnoses in the Swedish Prescribed Drug Register and National Patient Register, between July 2005 and December 2009 (N = 250 691). Medical records for 1952 randomly selected individuals were reviewed to estimate the proportion of individuals with the following: (1) asthma/eczema medication that fulfilled predefined criteria of asthma/eczema (positive predictive value (PPV)) and (2) a register-based asthma diagnosis verified as asthma by predefined criteria. Results Positive predictive value for asthma by predefined criteria ranged between 0.75 (95% CI: 0.70-0.78) to 0.94 (95% CI: 0.91-0.96), depending on age group. In pre-school children, PPV for asthma in combination with obstructive bronchitis was 0.87 (95% CI: 0.83-0.90), and PPV for eczema was estimated to 0.45 (95% CI: 0.38-0.51). Eighty percent of children 0-4.5 years and 99% of children >4.5-17 years with a register-based diagnosis of asthma were verified as asthmatics. Conclusion Asthma medication is a suitable proxy for asthma in older children and adults; the same approach is insufficient for eczema. This validation study of two Swedish registers opens for future large nation-wide register-based studies on asthma. Copyright (C) 2013 John Wiley & Sons, Ltd.

Place, publisher, year, edition, pages
2013. Vol. 22, no 8, 850-860 p.
Keyword [en]
allergic diseases, asthma outcome research, asthma pharmacology, disease proxy, nationwide, prescription prevalence, pharmacoepidemiology
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:oru:diva-56673DOI: 10.1002/pds.3465ISI: 000322016300007PubMedID: 23754713OAI: oai:DiVA.org:oru-56673DiVA: diva2:1083570
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2017-03-21Bibliographically approved

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