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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records</title>
<author><name sortKey="Williamson, Tyler" sort="Williamson, Tyler" uniqKey="Williamson T" first="Tyler" last="Williamson">Tyler Williamson</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-0120367">Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Green, Michael E" sort="Green, Michael E" uniqKey="Green M" first="Michael E." last="Green">Michael E. Green</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-0120367">Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Birtwhistle, Richard" sort="Birtwhistle, Richard" uniqKey="Birtwhistle R" first="Richard" last="Birtwhistle">Richard Birtwhistle</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-0120367">Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khan, Shahriar" sort="Khan, Shahriar" uniqKey="Khan S" first="Shahriar" last="Khan">Shahriar Khan</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Garies, Stephanie" sort="Garies, Stephanie" uniqKey="Garies S" first="Stephanie" last="Garies">Stephanie Garies</name>
<affiliation><nlm:aff id="af3-0120367">Department of Family Medicine, University of Calgary, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wong, Sabrina T" sort="Wong, Sabrina T" uniqKey="Wong S" first="Sabrina T." last="Wong">Sabrina T. Wong</name>
<affiliation><nlm:aff id="af4-0120367">School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Natarajan, Nandini" sort="Natarajan, Nandini" uniqKey="Natarajan N" first="Nandini" last="Natarajan">Nandini Natarajan</name>
<affiliation><nlm:aff id="af5-0120367">Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Manca, Donna" sort="Manca, Donna" uniqKey="Manca D" first="Donna" last="Manca">Donna Manca</name>
<affiliation><nlm:aff id="af6-0120367">Department of Family Medicine, University of Alberta, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Drummond, Neil" sort="Drummond, Neil" uniqKey="Drummond N" first="Neil" last="Drummond">Neil Drummond</name>
<affiliation><nlm:aff id="af6-0120367">Department of Family Medicine, University of Alberta, Alberta, Canada</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25024246</idno>
<idno type="pmc">4096475</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096475</idno>
<idno type="RBID">PMC:4096475</idno>
<idno type="doi">10.1370/afm.1644</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000518</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records</title>
<author><name sortKey="Williamson, Tyler" sort="Williamson, Tyler" uniqKey="Williamson T" first="Tyler" last="Williamson">Tyler Williamson</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-0120367">Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Green, Michael E" sort="Green, Michael E" uniqKey="Green M" first="Michael E." last="Green">Michael E. Green</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-0120367">Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Birtwhistle, Richard" sort="Birtwhistle, Richard" uniqKey="Birtwhistle R" first="Richard" last="Birtwhistle">Richard Birtwhistle</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-0120367">Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khan, Shahriar" sort="Khan, Shahriar" uniqKey="Khan S" first="Shahriar" last="Khan">Shahriar Khan</name>
<affiliation><nlm:aff id="af1-0120367">Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Garies, Stephanie" sort="Garies, Stephanie" uniqKey="Garies S" first="Stephanie" last="Garies">Stephanie Garies</name>
<affiliation><nlm:aff id="af3-0120367">Department of Family Medicine, University of Calgary, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wong, Sabrina T" sort="Wong, Sabrina T" uniqKey="Wong S" first="Sabrina T." last="Wong">Sabrina T. Wong</name>
<affiliation><nlm:aff id="af4-0120367">School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Natarajan, Nandini" sort="Natarajan, Nandini" uniqKey="Natarajan N" first="Nandini" last="Natarajan">Nandini Natarajan</name>
<affiliation><nlm:aff id="af5-0120367">Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Manca, Donna" sort="Manca, Donna" uniqKey="Manca D" first="Donna" last="Manca">Donna Manca</name>
<affiliation><nlm:aff id="af6-0120367">Department of Family Medicine, University of Alberta, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Drummond, Neil" sort="Drummond, Neil" uniqKey="Drummond N" first="Neil" last="Drummond">Neil Drummond</name>
<affiliation><nlm:aff id="af6-0120367">Department of Family Medicine, University of Alberta, Alberta, Canada</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Annals of Family Medicine</title>
<idno type="ISSN">1544-1709</idno>
<idno type="eISSN">1544-1717</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
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</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>PURPOSE</title>
<p>The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is Canada’s first national chronic disease surveillance system based on electronic health record (EHR) data. The purpose of this study was to develop and validate case definitions and case-finding algorithms used to identify 8 common chronic conditions in primary care: chronic obstructive pulmonary disease (COPD), dementia, depression, diabetes, hypertension, osteoarthritis, parkinsonism, and epilepsy.</p>
</sec>
<sec><title>METHODS</title>
<p>Using a cross-sectional data validation study design, regional and local CPCSSN networks from British Columbia, Alberta (2), Ontario, Nova Scotia, and Newfoundland participated in validating EHR case-finding algorithms. A random sample of EHR charts were reviewed, oversampling for patients older than 60 years and for those with epilepsy or parkinsonism. Charts were reviewed by trained research assistants and residents who were blinded to the algorithmic diagnosis. Sensitivity, specificity, and positive and negative predictive values (PPVs, NPVs) were calculated.</p>
</sec>
<sec><title>RESULTS</title>
<p>We obtained data from 1,920 charts from 4 different EHR systems (Wolf, Med Access, Nightingale, and PS Suite). For the total sample, sensitivity ranged from 78% (osteoarthritis) to more than 95% (diabetes, epilepsy, and parkinsonism); specificity was greater than 94% for all diseases; PPV ranged from 72% (dementia) to 93% (hypertension); NPV ranged from 86% (hypertension) to greater than 99% (diabetes, dementia, epilepsy, and parkinsonism).</p>
</sec>
<sec><title>CONCLUSIONS</title>
<p>The CPCSSN diagnostic algorithms showed excellent sensitivity and specificity for hypertension, diabetes, epilepsy, and parkinsonism and acceptable values for the other conditions. CPCSSN data are appropriate for use in public health surveillance, primary care, and health services research, as well as to inform policy for these diseases.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Fam Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann Fam Med</journal-id>
<journal-id journal-id-type="hwp">annalsfm</journal-id>
<journal-title-group><journal-title>Annals of Family Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">1544-1709</issn>
<issn pub-type="epub">1544-1717</issn>
<publisher><publisher-name>American Academy of Family Physicians</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25024246</article-id>
<article-id pub-id-type="pmc">4096475</article-id>
<article-id pub-id-type="doi">10.1370/afm.1644</article-id>
<article-id pub-id-type="publisher-id">0120367</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Methodology</subject>
</subj-group>
</article-categories>
<title-group><article-title>Validating the 8 CPCSSN Case Definitions for Chronic Disease Surveillance in a Primary Care Database of Electronic Health Records</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Williamson</surname>
<given-names>Tyler</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af1-0120367">1</xref>
<xref ref-type="aff" rid="af2-0120367">2</xref>
<xref ref-type="corresp" rid="c1-0120367"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Green</surname>
<given-names>Michael E.</given-names>
</name>
<degrees>MD, MPH, CCFP, FCFP</degrees>
<xref ref-type="aff" rid="af1-0120367">1</xref>
<xref ref-type="aff" rid="af2-0120367">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Birtwhistle</surname>
<given-names>Richard</given-names>
</name>
<degrees>MD, MSc, FCFP</degrees>
<xref ref-type="aff" rid="af1-0120367">1</xref>
<xref ref-type="aff" rid="af2-0120367">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Khan</surname>
<given-names>Shahriar</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="af1-0120367">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Garies</surname>
<given-names>Stephanie</given-names>
</name>
<degrees>MPH</degrees>
<xref ref-type="aff" rid="af3-0120367">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wong</surname>
<given-names>Sabrina T.</given-names>
</name>
<degrees>PhD, RN</degrees>
<xref ref-type="aff" rid="af4-0120367">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Natarajan</surname>
<given-names>Nandini</given-names>
</name>
<degrees>MD, CCFP</degrees>
<xref ref-type="aff" rid="af5-0120367">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Manca</surname>
<given-names>Donna</given-names>
</name>
<degrees>MD, MSc, CCFP, FCFP</degrees>
<xref ref-type="aff" rid="af6-0120367">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Drummond</surname>
<given-names>Neil</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af6-0120367">6</xref>
</contrib>
</contrib-group>
<aff id="af1-0120367"><label>1</label>
Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada</aff>
<aff id="af2-0120367"><label>2</label>
Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada</aff>
<aff id="af3-0120367"><label>3</label>
Department of Family Medicine, University of Calgary, Alberta, Canada</aff>
<aff id="af4-0120367"><label>4</label>
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada</aff>
<aff id="af5-0120367"><label>5</label>
Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada</aff>
<aff id="af6-0120367"><label>6</label>
Department of Family Medicine, University of Alberta, Alberta, Canada</aff>
<author-notes><corresp id="c1-0120367">CORRESPONDING AUTHOR: Tyler Williamson, PhD, Centre for Studies in Primary Care, 220 Bagot St, Kingston, Ontario, Canada K7L 5E9, <email>tylerw@cpcssn.org</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>7</month>
<year>2014</year>
</pub-date>
<volume>12</volume>
<issue>4</issue>
<fpage>367</fpage>
<lpage>372</lpage>
<history><date date-type="received"><day>17</day>
<month>9</month>
<year>2013</year>
</date>
<date date-type="rev-recd"><day>30</day>
<month>1</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>22</day>
<month>2</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>© 2014 Annals of Family Medicine, Inc.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="367.pdf"></self-uri>
<abstract><sec><title>PURPOSE</title>
<p>The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is Canada’s first national chronic disease surveillance system based on electronic health record (EHR) data. The purpose of this study was to develop and validate case definitions and case-finding algorithms used to identify 8 common chronic conditions in primary care: chronic obstructive pulmonary disease (COPD), dementia, depression, diabetes, hypertension, osteoarthritis, parkinsonism, and epilepsy.</p>
</sec>
<sec><title>METHODS</title>
<p>Using a cross-sectional data validation study design, regional and local CPCSSN networks from British Columbia, Alberta (2), Ontario, Nova Scotia, and Newfoundland participated in validating EHR case-finding algorithms. A random sample of EHR charts were reviewed, oversampling for patients older than 60 years and for those with epilepsy or parkinsonism. Charts were reviewed by trained research assistants and residents who were blinded to the algorithmic diagnosis. Sensitivity, specificity, and positive and negative predictive values (PPVs, NPVs) were calculated.</p>
</sec>
<sec><title>RESULTS</title>
<p>We obtained data from 1,920 charts from 4 different EHR systems (Wolf, Med Access, Nightingale, and PS Suite). For the total sample, sensitivity ranged from 78% (osteoarthritis) to more than 95% (diabetes, epilepsy, and parkinsonism); specificity was greater than 94% for all diseases; PPV ranged from 72% (dementia) to 93% (hypertension); NPV ranged from 86% (hypertension) to greater than 99% (diabetes, dementia, epilepsy, and parkinsonism).</p>
</sec>
<sec><title>CONCLUSIONS</title>
<p>The CPCSSN diagnostic algorithms showed excellent sensitivity and specificity for hypertension, diabetes, epilepsy, and parkinsonism and acceptable values for the other conditions. CPCSSN data are appropriate for use in public health surveillance, primary care, and health services research, as well as to inform policy for these diseases.</p>
</sec>
</abstract>
<kwd-group><kwd>primary health care</kwd>
<kwd>chronic disease</kwd>
<kwd>validation studies</kwd>
<kwd>electronic health records</kwd>
<kwd>sensitivity and specificity</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>cover-date</meta-name>
<meta-value>July/August 2014</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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