Scientific Publications Database

Article Title: Enriched administrative data can be used to retrospectively identify all known cases of primary subarachnoid hemorrhage
Authors: English, Shane W.; McIntyre, Lauralyn; Fergusson, Dean; Turgeon, Alexis; Sun, Cathy; dos Santos, Marlise P.; Lum, Cheemun; Sinclair, John; Forster, Alan; van Walraven, Carl
Journal: JOURNAL OF CLINICAL EPIDEMIOLOGY Volume 70
Date of Publication:2016
Abstract:
Objective: We derived and validated a method to screen all hospital admissions for 1 subarachnoid hemorrhage (SAH) by retrospectively implementing recognized diagnostic criteria.Study Design and Setting: A screen for 1 SAH was developed using two previously created registries. Screen-positive cases underwent diagnosis confirmation with primary record review. A review of all patient hospital encounters with the diagnostic code for 1 SAH, and cross-referencing with an existing SAH registry was undertaken to identify missed cases.Results: Three subscreens were combined to form the 1 SAH screen (sensitivity: 98.4% [95% CI: 91.7-99.7%], specificity: 93.4% [95% CI: 90.4-95.4%], n = 455 patients in validation sample). From 1,699 screen-positive admissions between July 1, 2002 and June 30, 2011, we identified 831 true cases of SAH of which 632 patients had 1 SAH from ruptured aneurysm/arteriovenous malformation (sensitivity: 96.5% [95% CI: 94.8-97.8%], specificity: 40.3% [95% CI: 38.1-42.6%]). A review of all encounters with a diagnostic code for 1 SAH yielded additional 22 true cases.Conclusion: When positive, our 1 SAH screen significantly increases the probability of this diagnosis in a particular hospitalization. The addition of patient hospitalizations encoded with the diagnostic code for 1 SAH improved sensitivity. Together, these methods represent the best way to retrospectively identify all cases of 1 SAH within an extensive sampling frame. (C) 2016 Elsevier Inc. All rights reserved.