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Use of administrative data for national surveillance of osteoporosis and related fractures in Canada: results from a feasibility study

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Abstract

Summary

Using administrative data healthcare databases from five Canadian provinces, we compared prevalence estimates of diagnosed osteoporosis and incidence rates for related fractures in Canada. The algorithms adopted showed consistent age and sex patterns across all provinces and will be suitable for national surveillance and monitoring.

Purpose

This study aims to evaluate the feasibility of using provincial population-based administrative data to develop a national surveillance system of diagnosed osteoporosis and related fractures (forearm, humerus, vertebra, pelvis, and hip) in Canada.

Methods

Linked healthcare databases from five provinces representing approximately 85 % of the Canadian population were used. Multiple algorithms combining hospitalizations, physician visits, and osteoporosis prescription drug dispensations were evaluated in each province. The adopted algorithms for diagnosed osteoporosis and incident fractures combined hospitalizations and physician visits based on 3 years and 1 year of data, respectively. Sex-specific age-standardized osteoporosis prevalence and fracture incidence rates were estimated for each province from 1995/1996 to 2007/2008.

Results

Age-standardized prevalence of diagnosed osteoporosis in those ≥50 years increased over the study period but stabilized in the most recent years. Using the adopted algorithm produced provincial estimates ranging from 5.6 to 10.5 % for 2007/2008, with consistent age and sex patterns across provinces. The use of osteoporosis drug data resulted in higher osteoporosis estimates compared with estimates without drug data. Age-standardized incidence of fractures in those ≥40 years showed similar age and sex patterns across all provinces. The highest level of agreement among provinces was for hip and humerus fracture rates, with wider provincial variation for forearm, vertebra, and pelvis fractures.

Conclusions

Our results are consistent with previous validation works and confirm that the algorithms adopted will be suitable for the national monitoring of diagnosed osteoporosis and related fractures. A similar approach may be applicable to other countries with high-quality administrative data.

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References

  1. Tarride JE, Hopkins RB, Leslie WD et al (2012) The burden of illness of osteoporosis in Canada. Osteoporosis Int 23:2591–2600

    Google Scholar 

  2. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733

    Article  CAS  PubMed  Google Scholar 

  3. Public Health Agency of Canada (2009) Report from the National Diabetes Surveillance System: diabetes in Canada, 2009. Available from http://www.phac-aspc.gc.ca/publicat/2009/ndssdic-snsddac-09/index-eng.php.

  4. Public Health Agency of Canada (2010) Report from the Canadian Chronic Disease Surveillance System: hypertension in Canada, 2010. Available from http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/ccdss-snsmc-2010/index-eng.php.

  5. Leslie WD, Lix LM, Yogendran MS (2011) Validation of a case definition for osteoporosis disease surveillance. Osteoporosis Int 1(22):37–46

    Article  Google Scholar 

  6. Lix LM, Azimaee M, Osman BA et al (2012) Osteoporosis related fracture case definitions for population-based administrative data. BMC Public Health 12:301

    Article  PubMed Central  PubMed  Google Scholar 

  7. Lix LM, Yogendran M, Leslie WD, Shaw SY, Baumgartner R, Bowman C, Metge C, Gumel A, James RC, Hux JF (2008) Using multiple data features improved the validity of osteoporosis case ascertainment from administrative data. J ClinEpidemiol 61:1250–1260

    Google Scholar 

  8. Jean S, Candas B, Belzile E et al (2012) Algorithms can be used to identify fragility fracture cases in physician claims databases. Osteoporosis Int 23:483–501

    Article  CAS  Google Scholar 

  9. Sund R (2007) Utilization of routinely collected administrative data in monitoring the incidence of aging dependent hip fracture. Epidemiol Perspect Innov 7(4):2

    Article  Google Scholar 

  10. Curtis JR, Mudano AS, Solomon DH, Xi J, Melton ME, Saag KG (2009) Identification and validation of vertebral compression fractures using administrative claims data. Med Care 47(1):69–72

    Article  PubMed Central  PubMed  Google Scholar 

  11. Narongroeknawin P, Patkar NM, Shakoory B, Jain A, Curtis JR, Delzell E, Lander PH, Lopez-Ben RR, Pitt MJ, Safford MM, Volgas DA, Saag KG (2012) Validation of diagnostic codes for subtrochanteric, diaphyseal, and atypical femoral fractures using administrative claims data. J Clin Densitom 15(1):92–102

    Article  PubMed  Google Scholar 

  12. Abrahamsen B, Vestergaard P (2010) Declining incidence of hip fractures and the extent of use of anti-osteoporotic therapy in Denmark 1997-2006. Osteoporos Int 21:373–380

    Article  CAS  PubMed  Google Scholar 

  13. Landfeldt E, Strom O, Robbins S et al (2012) Adherence to treatment of primary osteoporosis and its association to fractures-the Swedish Adherence Register Analysis (SARA). Osteoporos Int 23:433–443

    Article  CAS  PubMed  Google Scholar 

  14. Icks A, Haastert B, Wildner M et al (2008) Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 19:1139–1145

    Article  CAS  PubMed  Google Scholar 

  15. Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674

    Article  CAS  PubMed  Google Scholar 

  16. Ettinger B, Black DM, Wson-Hughes B et al (2010) Updated fracture incidence rates for the US version of FRAX. Osteoporos Int 21:25–33

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Leslie WD, Lix LM, Langsetmo L et al (2011) Construction of a FRAX® model for the assessment of fracture probability in Canada and implications for treatment. Osteoporos Int 22:817–827

    Article  CAS  PubMed  Google Scholar 

  18. Curtis JR, Taylor AJ, Matthews RS, Ray MN, Becker DJ, Gary LC, Kilgore ML, Morrisey MA, Saag KG, Warriner A et al (2009) "Pathologic" fractures: should these be included in epidemiologic studies of osteoporotic fractures? Osteoporos Int 20:1969–1972

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Osteoporosis Canada: Breaking Barriers, Not Bones: 2008 National Report Card on Osteoporosis Care, Toronto: Osteoporosis Canada, 2008. Available from http://www.osteoporosis.ca/multimedia/images/english/home/2008NationalReportCard_Eng.pdf.

  20. Lix LM, Walker R, Quan H, Nesdole R, Yang J, Chen G, for the CHEP-ORTF Hypertension Outcomes and Surveillance Team (2012) Features of physician services databases in Canada. Chronic Diseases and Injuries in Canada 32(4):186–193

    CAS  PubMed  Google Scholar 

  21. Garriguet D (2011) Bone health: osteoporosis, calcium and vitamin D. Health Rep (Statistics Canada catalogue No. 82-003-X) 22(3):7–14. Available from http://www.statcan.gc.ca/pub/82-003-x/2011003/article/11515-eng.htm.

  22. Kisely S, Lin E, Lesage A, Gilbert C, Smith M, Campbell LA, Vasiliadis HM (2009) Use of administrative data for the surveillance of mental disorders in 5 provinces. Can J Psychiatry 54(8):571–575

    PubMed  Google Scholar 

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Acknowledgments

CCDSS Osteoporosis Working Group: Jacques Brown, Susan Jaglal, Sonia Jean, William D. Leslie, Lisa M. Lix, Pat McCrea, Louise McRae, Suzanne Morin, Siobhan O’Donnell, Jay Onysko, Alexandra Papaioannou, Kim Reimer, Louis Rochette, Kerry Siminoski, and Larry Svenson. Working Group members assisted with the interpretation of data, revising the manuscript critically for important intellectual content, and approving its submission. The conclusions in this manuscript reflect the opinions of individual experts and not their affiliated organizations.

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  1. Chronic Disease Surveillance and Monitoring Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada

    S. O’Donnell

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  1. S. O’Donnell
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Canadian Chronic Disease Surveillance System (CCDSS) Osteoporosis Working Group

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Correspondence to S. O’Donnell.

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O’Donnell, S., Canadian Chronic Disease Surveillance System (CCDSS) Osteoporosis Working Group. Use of administrative data for national surveillance of osteoporosis and related fractures in Canada: results from a feasibility study. Arch Osteoporos 8, 143 (2013). https://doi.org/10.1007/s11657-013-0143-2

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  • DOI: https://doi.org/10.1007/s11657-013-0143-2

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