Creation of an Algorithm to Identify Non-traumatic Spinal Cord Dysfunction Patients in Canada Using Administrative Health Data

Top Spinal Cord Inj Rehabil, 2017 · DOI: 10.1310/sci2304-324 · Published: January 1, 2017

Spinal Cord Injury Healthcare Public Health

Simple Explanation

This study addresses the lack of a standard way to identify non-traumatic spinal cord dysfunction (NTSCD) cases using Canadian health data. This makes it hard to understand how common NTSCD is and to plan healthcare services. The researchers created a method to find NTSCD cases in large databases of hospital, emergency, and rehabilitation records. They used combinations of diagnosis codes to identify patients with neurological issues and underlying non-traumatic causes. The algorithm categorizes patients into 'most likely,' 'probable,' and 'possible' NTSCD groups, based on how NTSCD was recorded in their health records. This is a first step toward accurately measuring NTSCD incidence and prevalence in Canada.

Study Duration

7 Years

Participants

23,703 patients with neurological impairment

Evidence Level

Not specified

Key Findings

1
The algorithm identified three groups of patients: 'most likely NTSCD' (6,362), 'probable NTSCD' (2,777), and 'possible NTSCD' (11,179).
2
A significant portion of 'most likely NTSCD' cases (one-third) had neurological impairment coded only in inpatient rehabilitation records, suggesting that both acute care and rehabilitation data are needed for comprehensive identification.
3
Spinal stenosis of the lumbar region was the most commonly recorded etiology for NTSCD in the 'most likely' group.

Research Summary

This study developed an algorithm to identify NTSCD patients using Canadian health administrative data, addressing the lack of standardized methods and the need for accurate incidence and prevalence estimates. The algorithm uses a combination of diagnostic codes for neurological impairment and NTSCD etiology to classify patients into 'most likely,' 'probable,' and 'possible' NTSCD groups. The findings suggest that both acute care and inpatient rehabilitation records are necessary to comprehensively identify NTSCD cases, and that spinal stenosis is a common underlying cause.

Practical Implications

Improved NTSCD Epidemiology

The algorithm can be used to estimate the incidence and prevalence of NTSCD more accurately, which is crucial for resource allocation and healthcare planning.

Enhanced Research

The methodology and findings can inform future research initiatives on NTSCD, leading to a better understanding of the condition and improved care.

International Comparisons

Using the International Dataset for NTSCI etiology classifications facilitates comparisons with other studies conducted globally.

Study Limitations

1
Lack of clinical consensus regarding underlying causes of NTSCD.
2
Potential for falsely negative cases due to the assumption that neurological impairment and NTSCD etiology are linked when they may be separate events.
3
Different coding guidelines in other countries may limit the generalizability of the algorithm.

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