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Category: Diagnosing asthma

Diagnosing asthma: DISCUSSION (4)

Thus, the estimates of prevalence derived from the survey and the administrative data include two overlapping groups of people. In each, the diagnosis of asthma seems justifiable, but the agreement between the survey and the data is only moderate to substantial. To put this in perspective, a number of clinical conditions show measures of diagnostic…

Diagnosing asthma: DISCUSSION (3)

Asthma is difficult to define; physicians may use ICD-9 codes for nonspecified bronchitis, chronic bronchitis, emphysema or chronic airflow obstruction instead of asthma when seeing a patient . Further, 20% to 50% of those reporting asthma attacks or medication use who had not visited a physician for asthma in the five years before the survey…

Diagnosing asthma: DISCUSSION (2)

Our results are unlikely to have been affected by the inability to link more than 83.2% of participants in the survey to physician claims. Linked and nonlinked individuals did not differ with respect to sex, age or the frequency of symptoms reported. The incomplete linkage may be due to strict requirements for matching and to…

Diagnosing asthma: DISCUSSION (1)

Overall, the level of agreement between questionnaire responses and physician claims data is moderate . In comparison with studying one year, studying two years of database contacts increased the agreement with survey results. Studying more than two years of physician contact had no effect on the level of agreement, although the sensitivity of the database…

Diagnosing asthma: RESULTS (4)

Among 2479 subjects in the analysis, 1031 (41.6%) were men and 1448 (58.4%) were women. The agreement between responses to the questionnaire and physician claims was similar for both sexes. Subjects were divided into current smokers (n=756, 30.5%), ex-smokers (n=671, 27.1%) and never-smokers (n=1051, 42.4%). Again, the agreement did not differ significantly by smoking groups….

Diagnosing asthma: RESULTS (3)

Two groups of subjects were responsible for a less than perfect agreement between the questionnaire and physician claims data. The first group were subjects seen by a physician for asthma (according to physician claims) who did not report an asthma attack in the previous 12 months or asthma medication use. Table 1 shows that 98…

Diagnosing asthma: RESULTS (2)

Table 1 cross-tabulates responses from the questionnaire with physician claims. The agreement, indicated by kappa coefficients, between physician visits for asthma during one year before the survey and responses to survey questions about asthma attacks and the use of medication was moderate (k=0.45 to 0.50) . Agreement improved substantially if two years of physician contacts…

Diagnosing asthma: RESULTS (1)

Of the 2479 subjects with complete information from both the survey and the administrative data, 169 (6.8%) reported an asthma attack in the previous 12 months and 172 (6.9%) were on asthma medication at that time. Two hundred fourteen (8.6%) reported either having an asthma attack or taking asthma medication, and 127 (5.1%) reported both…

Diagnosing asthma: METHODS (2)

The Manitoba Population Health Research Repository contains records of all physician contacts in hospitals and in offices for the total population of Manitoba. A comprehensive population registry facilitates record linkage using a scrambled personal health identification number (PHIN), unique for each individual. To maintain the anonymity and confidentiality of survey participants, Manitoba Health used the…

Diagnosing asthma: METHODS (1)

The methods of sample selection and examining procedures have been described in detail . In brief, a sample of 18,000 randomly selected telephone numbers for the City of Winnipeg was obtained. From March 1993 to May 1994, interviewers systematically called these numbers, and following an appropriate introduction, they determined whether the number was residential and…

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