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      Positive Predictive Value of Benign Prostatic Hyperplasia and Acute Urinary Retention in the Danish National Patient Registry: A Validation Study

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          Abstract

          Background and Aim

          Benign prostatic hyperplasia comprises a significant burden to ageing men due to frequently associated lower urinary tract symptoms and the risk of developing serious complications, such as acute urinary retention. Healthcare databases are a valuable source of epidemiological research; however, continuous validation of definitions is imperative. We examined the positive predictive values of International Classification of Diseases, 10th Revision (ICD-10), diagnostic coding for benign prostatic hyperplasia and acute urinary retention in men in the Danish National Patient Registry.

          Methods

          We investigated a random sample of 100 men diagnosed with benign prostatic hyperplasia and 100 men diagnosed with acute urinary retention between 2011 and 2017 in the Central Denmark Region. Using medical record review as reference standard, we estimated the positive predictive value with corresponding 95% confidence intervals (CI) overall and stratified by age, type of hospital (university hospital vs regional hospital), type of hospital contact (inpatient, outpatient or emergency room), calendar year group (2011–2013, 2014–2017), and department (department of urology, geriatrics, endocrinology or emergency room).

          Results

          Medical records were available for all 200 sampled patients. We found an overall positive predictive value (PPV) of 95% (95% CI: 89–98%) for benign prostatic hyperplasia and 98% (95% CI: 93–99%) for acute urinary retention. The PPVs were consistent across age, type of hospital, type of hospital contact, calendar year group, and department.

          Conclusion

          The PPVs of ICD-10 codes for benign prostatic hyperplasia and acute urinary retention recorded in the Danish National Patient Registry are high.

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          Most cited references13

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          The Danish National Patient Registry: a review of content, data quality, and research potential

          Background The Danish National Patient Registry (DNPR) is one of the world’s oldest nationwide hospital registries and is used extensively for research. Many studies have validated algorithms for identifying health events in the DNPR, but the reports are fragmented and no overview exists. Objectives To review the content, data quality, and research potential of the DNPR. Methods We examined the setting, history, aims, content, and classification systems of the DNPR. We searched PubMed and the Danish Medical Journal to create a bibliography of validation studies. We included also studies that were referenced in retrieved papers or known to us beforehand. Methodological considerations related to DNPR data were reviewed. Results During 1977–2012, the DNPR registered 8,085,603 persons, accounting for 7,268,857 inpatient, 5,953,405 outpatient, and 5,097,300 emergency department contacts. The DNPR provides nationwide longitudinal registration of detailed administrative and clinical data. It has recorded information on all patients discharged from Danish nonpsychiatric hospitals since 1977 and on psychiatric inpatients and emergency department and outpatient specialty clinic contacts since 1995. For each patient contact, one primary and optional secondary diagnoses are recorded according to the International Classification of Diseases. The DNPR provides a data source to identify diseases, examinations, certain in-hospital medical treatments, and surgical procedures. Long-term temporal trends in hospitalization and treatment rates can be studied. The positive predictive values of diseases and treatments vary widely (<15%–100%). The DNPR data are linkable at the patient level with data from other Danish administrative registries, clinical registries, randomized controlled trials, population surveys, and epidemiologic field studies – enabling researchers to reconstruct individual life and health trajectories for an entire population. Conclusion The DNPR is a valuable tool for epidemiological research. However, both its strengths and limitations must be considered when interpreting research results, and continuous validation of its clinical data is essential.
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            Probable Inference, the Law of Succession, and Statistical Inference

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              EPIDEMIOLOGY:When an Entire Country Is a Cohort

              L. Frank (2000)
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                Author and article information

                Journal
                Clin Epidemiol
                Clin Epidemiol
                clep
                clinepid
                Clinical Epidemiology
                Dove
                1179-1349
                16 November 2020
                2020
                : 12
                : 1281-1285
                Affiliations
                [1 ]Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus N, Denmark
                [2 ]Department of Urology, Aarhus University Hospital , Aarhus N, Denmark
                Author notes
                Correspondence: Maria Bisgaard Bengtsen Department of Clinical Epidemiology, Aarhus University Hospital , Olof Palmes Allé 43-45, Aarhus N, DenmarkTel +45 87155872Fax +45 87167215 Email mariabb@clin.au.dk
                Author information
                http://orcid.org/0000-0002-4241-7213
                http://orcid.org/0000-0003-0112-5801
                http://orcid.org/0000-0001-6110-5891
                Article
                278554
                10.2147/CLEP.S278554
                7678697
                33235508
                45bae432-764c-4e94-a2c9-c232160645d6
                © 2020 Bengtsen et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 24 August 2020
                : 22 October 2020
                Page count
                Figures: 2, References: 13, Pages: 5
                Funding
                Funded by: did not receive any specific grant;
                This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
                Categories
                Original Research

                Public health
                epidemiology,benign prostatic hyperplasia,acute urinary retention,validity
                Public health
                epidemiology, benign prostatic hyperplasia, acute urinary retention, validity

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