QUERY Validation of cases from PMSI: through medical records
Transcription
QUERY Validation of cases from PMSI: through medical records
Mlle VERRIERE Amandine a, Dr. TROMBERT Béatrice b, Pr. VERGNON Jean-Michel c, a, Dr. BELLET Florelle a, Dr. GUY Claire a, Dr. MOUNIER Geneviève a, Dr. MARSILLE Fakhria a, Dr. ROY Michel a, Dr. BEYENS Marie-Noëlle a Pharmacovigilance - HOPITAL NORD, ST ETIENNE - FRANCE, b Service de Santé Publique et d'Information Médicale - HOPITAL NORD, ST ETIENNE - FRANCE, c Pneumologie - HOPITAL NORD, ST ETIENNE - FRANCE • Under-reporting (estimated at 92-96%) is a limit of pharmacovigilance daily. • PMSI is a medical administrative hospital database using ICD codes (International Classification of Disease). • To compare the PMSI database and the pharmacovigilance database about the example of drug-induced interstitial lung disease. QUERY From 2009 to 2011, at CHU of Saint-Etienne PMSI “drug induced interstitial BNPV lung disease” -Side effect: pneumopathie NCA -ICD 10*codesJ70.2 J70.3 J70.4 (High Level Term*)*Meddra codie *10th International Classification of Disease Validation of cases from PMSI: through medical records VALIDATION PMSI’S CASES THROUGH MEDICAL RECORDS 4 35 PMSI CRPV 4 STATISTICAL ANALYSIS capture-recapture method to estimate: - total number of cases from two sources from the same population - under-reporting. PMSI 28 CRPV CAPTURE-RECATURE METHOD PATIENTS CHARACTERISTICS *common case counted once 81 « TOP 5 » OF DRUGS 28 27 1 • • • • 4 cases CRPV versus 28 cases PMSI Drug-induced reactions’ codes in the CIM-10 +++ Cases reported to CRPV concern younger patients Capture-recapture method: fast and easy to apply with 2 databases • low statistical power du to low number: • of cases (31 cases) • of common cases between the two bases (1) • 20% of false positives in PMSI’s cases (coding errors +++) but low compared to another similar study: 94,5% false positives* *E. TACQUET, A. DAVELUY, H. GENIAUX. Hepatic adverse drug reactions: data from the hospital database in a teaching hospital. P2T Abstracts 2012. 2012;26(Suppl.1):428. 112 [IC 95% 0-299] Improving PMSI : To decrease false positive cases: • Using a third data source: biological data for example * • Improving coding by developping financial benefice •Using the PMSI more "oriented" in the future in pharmacovigilance * Rev Epidemiol Santé Publique, 2002; 50: 219-232 A. GALLAY, A. NARDONEI, V. VAILLANT, J.-C. DESENCLOS La méthode capture-recapture appliquée à l’épidémiologie: principes, limites et applications