Robustness of Prevalence Estimates Derived from Misclassified Data from Administrative Databases
Version of Record online: 27 SEP 2006
Volume 63, Issue 1, pages 272–279, March 2007
How to Cite
Ladouceur, M., Rahme, E., Pineau, C. A. and Joseph, L. (2007), Robustness of Prevalence Estimates Derived from Misclassified Data from Administrative Databases. Biometrics, 63: 272–279. doi: 10.1111/j.1541-0420.2006.00665.x
- Issue online: 16 APR 2007
- Version of Record online: 27 SEP 2006
- Received November 2005. Revised May 2006. Accepted May 2006.
- Administrative databases;
- Bayesian latent class models;
Summary Because primary data collection can be expensive, researchers are increasingly using information collected in medical administrative databases for scientific purposes. This information, however, is typically collected for reasons other than research, and many such databases have been shown to contain substantial proportions of misclassification errors. For example, many administrative databases contain fields for patient diagnostic codes, but these are often missing or inaccurate, in part because physician reimbursement schemes depend on medical acts performed rather than any diagnosis. Errors in ascertaining which individuals have a given disease bias not only prevalence estimates, but also estimates of associations between the disease and other variables, such as medication use. We attempt to estimate the prevalence of osteoarthritis (OA) among elderly Quebeckers using a government administrative database. We compare a naive estimate relying solely on the physician diagnoses of OA listed in the database to estimates from several different Bayesian latent class models which adjust for misclassified physician diagnostic codes via use of other available diagnostic clues. We find that the prevalence estimates vary widely, depending on the model used and assumptions made. We conclude that any inferences from these databases need to be interpreted with great caution, until further work estimating the reliability of database items is carried out.