Table 4 Validation of diagnoses in the Swedish Inpatient Register by sensitivity
From: External review and validation of the Swedish national inpatient register
Diagnosis | Proportion identified through the IPR (%) (sensitivity) | Comment | Main Author | PubMed ID | Year | Gold Standard (Reference) |
|---|---|---|---|---|---|---|
Cardiovascular disease | ||||||
Myocardial Infarction (MI) | 54/59 (91.5) | Cross-sectional, 1-year retrospective study. ≥20 year-olds from Degerfors area. | Elo [14] | 19084244 | 2009 | Data were obtained from IPR, hospital-based outpatient care and primary health care |
Myocardial infarction | 99/128 (77) | Â | Merlo [63] | 10870938 | 2000 | Men born 1914 |
Myocardial infarction | 113/144 (79) | Â | Merlo [63] | 10870938 | 2000 | The Skaraborg Hypertension Study |
Myocardial Infarction | 3201/4148 (77.2) | The researchers identified all MIs in Stockholm county in 1973 through the local IPR and the national Cause of Death Register (restricted to individuals living in Stockholm). | Ahlbom [64] | 721364 | 1978 | Swedish Cause of Death Register |
Myocardial infarction | 4746/5832 (81.4) of MI cases in community registers were found in IPR or the Cause of Death Register. | IPR and Cause of Death Register data from 1972-1981 for regions with IPR registers at the time. 81% of cases in community registers were found in IPR or Cause of Death Register. Meanwhile 85% of cases in IPR and the Cause of Death Register were found in Community registers (disregarding non-matching fatal cases). | Hammar [65] | 2066207 | 1991 | Community registers with myocardial infarctions |
Angina Pectoris | 86/196 (43.9) | Cross-sectional, 1-year retrospective study. ≥20 year-olds from Degerfors area. | Elo [14] | 19084244 | 2009 | Data were obtained from IPR, hospital-based outpatient care and primary health care |
Acute coronary syndrome (MI or unstable angina pectoris) | IPR from emergency department missed 2% of 218 patients with acute coronary syndrome. | Discharge diagnoses from emergency department, Lund University Hospital. | Forberg [66] | 18804783 | 2009 | MR. The study evaluates different methods to identify acute coronary syndrome in patients, using information not available in the IPR (e.g. ECG measurements). |
Non-specified ischemic heart disease | 44/206 (21.4) | Cross-sectional, 1-year retrospective study. ≥20 year-olds from Degerfors area. | Elo [14] | 19084244 | 2009 | Data were obtained from IPR, hospital-based outpatient care and primary health care |
Stroke (non-subarachnoidal hemorrhage) | 318/377 (84.4) | Data from a local stroke incidence study at the Örebro University Hospital. | Appelros | - | (PC, Feb 22) | Local stroke incidence study |
Non-fatal strokes | 3492/3732 (93.6) of all cases 3492/3562 (98.0) of estimated hospital cases | Patients aged 25-74 years in 1985-89. Criteria for acute stroke from MONICA study were comparable to WHO criteria. | Stegmayr [38] | 1291884 | 1992 | MONICA-population based stroke register |
Stroke | 75/79 (95) | Â | Merlo [63] | 10870938 | 2000 | The Skaraborg Hypertension Study |
Stroke | 76/81 (94) | Â | Merlo [63] | 10870938 | 2000 | "Men born 1914" |
Stroke | 384/456 (84.2) | First-time stroke. Restricted to the Lund county. | Hallström [67] | 17156265 | 2007 | * |
Stroke/Transient ischemic A. | 217/232 (93.5) | ULSAM. | Wiberg | - | (PC, Feb 12) | ULSAM |
Hypertension | 5,886/42,796 (13.7) | IPR data from the county Östergötland. | Wiréhn [68] | 17786807 | 2007 | County registers of primary health care, outpatient hospital care and inpatient care |
Hypertension | 74/838 (8.8) | Cross-sectional, 1-year retrospective study. ≥20 year-olds from Degerfors area. | Elo [14] | 19084244 | 2009 | Data were obtained from IPR, hospital-based outpatient care and primary health care |
Gestational hypertension | 108/166 (65.1) |  | Zetterström | - | (PC, March 3) | All pregnant women in Sweden have their blood pressure examined. |
Lipid disorders | 19/186 (10.2) | Cross-sectional, 1-year retrospective study. ≥20 year-olds from Degerfors area. | Elo [14] | 19084244 | 2009 | Data were obtained from IPR, hospital-based outpatient care and primary health care |
Autoimmune/immune-mediated diseases | ||||||
Rheumatoid arthritis (RA) | 489/1150 (42.5) | Malmö, Sweden, 1990-1994. According to the RA criteria of the American College of Rheumatology [41]. | Turesson [42] | 10461483 | 1999 | Data from all rheumatologists and general practictioners in Malmö city, 1997 |
Diabetes, type 1 and 2* | 92/394 (23.3) | Cross-sectional, 1-year retrospective study. ≥20 year-olds from Degerfors area. | Elo [14] | 19084244 | 2009 | Data were obtained from IPR, hospital-based outpatient care and primary health care |
Type 1 and type 2 diabetes mellitus * | 349/436 (80.0) patients with diabetes in "source 1" could be identified in the IPR | The researchers evaluated the presence of type 1 or type 2 diabetes among patients with atrial fibrillations at the Södersjukhuset Hospital. All but 8 patients in this validation had type 2 diabetes. | Friberg | - | (PC, Feb 8) | MR + biochemistry data + data on insulin or other medication against diabetes |
Type 1 and type 2 diabetes mellitus* | 4,348/18,134 (24.0) | IPR data from the county Östergötland. | Wiréhn [68] | 17786807 | 2007 | County registers of primary health care, outpatient hospital care and inpatient care |
Both type 1/2 diabetes and foot ulcer | 235/280 (83.9) admissions could be identified through the IPR | Based on 117 patients with deep foot infections and type 1 or 2 diabetes, referred to multidisciplinary foot-care team. Specificity for foot ulcers and concomitant diabetes was 98%. | Ragnarson- Tennvall [46] | 11123504 | 2000 | MR |
Infectious disease | ||||||
CNS infection in intensive care | ICD-9: 21/22 (95.4) ICD-10: 21/28 (75.0) | Specificity was 99.6% (ICD-9) and 99.7% (ICD-10). IPR data obtained through both primary and secondary diagnoses. | Gedeborg [69] | 17208121 | 2007 | ICU database diagnoses as reference |
Pneumonia in intensive care | ICD-9: 89/185 (48.1) ICD-10: 116/221 (52.5) | Specificity was 95.9% (ICD-9) and 95.8% (ICD-10). IPR data obtained through both main and secondary diagnoses. Using only primary diagnoses for pneumonia the specificity increased slightly but the sensitivity decreased to 31.2% and 38.2% respectively. | Gedeborg [69] | 17208121 | 2007 | ICU database diagnoses as reference |
Sepsis in intensive care | ICD-9: 85/186 (45.7) ICD-10: 94/179 (52.5) | Specificity was 97.5% (ICD-9) and 92.6% (ICD-10). IPR data obtained through both main and secondary diagnoses. | Gedeborg [69] | 17208121 | 2007 | ICU database diagnoses as reference, with inclusion in sepsis trials (IST) as secondary reference |
Tuberculosis | 12/15 (80) | Evaluation in patients with concomitant rheumatoid arthritis | Askling [70] | 15986370 | 2005 | MR |
Other disorders | ||||||
Carotid, infrainguinal bypass and aortic aneurysm (AAA) procedures | 10,861/11,638 (93.3) of patients identified through Swedvasc (Svenska kärlregistret) or the IPR could be identified in the IPR | (Swedvasc) started in 1987 and became nationwide 1994. In the paper by Troëng et al data on infraingunal and carotid bypass originated from 5 years (2000-2004), while data on aortic aneurysms originated from 1 year (2006). Divided the sensitivity figures were: Carotid 96.8%; Infrainguinal 92.3% and aortic aneurysm 88.9%. | Troëng [15] And by | 18851920 | 2008 | The Swedish Vascular Register (Swedvasc) |
Asthma | 1,377/18,451 (7.5) | IPR data from the county Östergötland. | Wiréhn [68] | 17786807 | 2007 | County registers of primary health care, outpatient hospital care and inpatient care |
Dementia | 23/87 (26) | Participants originated from the study "Aging in women and men: a longitudinal study of gender differences in health behaviour and health among the elderly (as part of the Swedish Twin Register). The specificity for dementia was 97% (399/411) | Dahl [71] | 18007116 | Â | MR + memory test scores etc. |
Dementia | 41.3% for prevalent cases and 42.3% for incident cases. | Participants originated from the study "Aging in women and men: a longitudinal study of gender differences in health behaviour and health among the elderly (as part of the Swedish Twin Register). The specificity for dementia was 97% (399/411) | Rizutto | Â | (PC, May 14) | Comparison between cases detected in IPR with cases derived from the Kungsholmen (KP) and SNAC-K Projects [72] |
Foot ulcer (only) | 249/280 (88.9%) of admissions could be identified through the IPR | Based on 117 patients with deep foot infections and type 1 or 2 diabetes, referred to multidisciplinary foot-care team. | Ragnarson- Tennvall [46] | 11123504 | 2000 | MR |
Chronic obstructive pulmonary disease | 1,290/4,812 (26.8) | IPR data from the county Östergötland. | Wiréhn [68] | 17786807 | 2007 | County registers of primary health care, outpatient hospital care and inpatient care |