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