Abstract
PurposeThe aim of this study is to validate medication proxies for the identification of children diagnosed with atopic disorders that can be applied in various types of epidemiological research.MethodsRecords of 7439 children, aged between 0 and 10 years, in the period 2001 until 2010, were retrieved from the Registration Network Groningen database, a general practitioners database in the north-eastern part of the Netherlands. The sensitivity and positive predictive value (PPV) of 22 medication proxies for the identification of children diagnosed with atopic disorders (asthma, atopic dermatitis, and allergic rhinitis) were computed using the registered diagnoses as gold standards. In addition, different capture periods (1 year, half year, and length of study period) for the detection of prescriptions were tested for all the medication proxies.ResultsThe highest PPV (0.84, 95 % CI 0.81–0.87) in combination with a sufficient sensitivity value (0.54, 95 % CI 0.50–0.57) for the identification of children diagnosed with asthma was yielded for the medication proxy, ≥2 prescriptions for anti-asthma medication within 1 year, including 1 inhaled steroid. PPV and sensitivity were even higher in the age group 6–10 years. The proxies designed for the identification of children diagnosed with atopic dermatitis and allergic rhinitis yielded only high PPVs (≥0.75) in combination with low sensitivity values (≤0.22). Altering the capture period for the detection of prescriptions to half a year or the length of the study period only affected sensitivity values.ConclusionChildren diagnosed with asthma can be identified reliably with a range of medication proxies. The use of prescription data for the identification of children diagnosed with atopic dermatitis and allergic rhinitis is questionable.
Highlights
Pharmacy databases with large numbers of prescriptions can provide valuable information for observational studies [1]
The use of prescription data for the identification of children diagnosed with atopic dermatitis and allergic rhinitis is questionable
Validation of the medication proxies for the identification of children diagnosed with asthma In Table 5, the sensitivity and positive predictive value (PPV) of the eight medication proxies for the identification of children diagnosed with asthma are shown
Summary
Pharmacy databases with large numbers of prescriptions can provide valuable information for observational studies [1]. The validity of using prescription data for the identification of children with atopic diseases in epidemiological research has been questioned, especially in children [2–8]. Various efforts have already been made to validate methods for the identification of asthma patients with prescription data [3–8]. A former study of our group investigated the accuracy of the use of several medication proxies for the identification of asthma patients (age 19–49) and showed that asthma patients could be identified reliably from prescription data [5]. Results from an adult patient population cannot directly be generalized to a population of children, especially not in the case of asthma [9].
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