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J Rheumatol. 2019 Mar 15. pii: jrheum.181121. doi: 10.3899/jrheum.181121. [Epub ahead of print]

Capture of Rheumatoid Arthritis Cases within Quebec Health Administrative Database.

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From the Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre. Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada. Address correspondence to . Dr. Sasha Bernatsky Centre for Outcomes Research & Evaluation of Research Institute of the McGill University Health Centre 5252 boul. de Maisonneuve Ouest, Office 3F.51 Montreal, QC, H4A 3S5.



Our objective was to calculate RA point prevalence estimates in the CARTaGENE cohort, as well as to estimate the sensitivity and specificity of our ascertainment approach, using physician billing data. We investigated the effects of using varying observation windows in the Régie de l'assurance maladie du Québec (RAMQ) health services administrative databases, alone or in combination with self-reported diagnoses and drugs.


We studied subjects enrolled in the CARTaGENE cohort, which recruited 19,995 participants from four metropolitan regions in Québec from August 2009 to October 2010. A series of Bayesian latent class models were developed to assess the effects of three factors: the number of years of billing data, the addition of self-reported information on RA diagnoses and drugs, and the adjustment for misclassification error.


The 2010 point-prevalence estimate among cohort members aged 40 to 69 years old, using physician billing plus self-report, adjusting for misclassification error in each source, was 0.9% (95% CrI: 0.7, 1.2) with a RAMQ sensitivity of 78.1% (95% CrI: 58.3, 92.6) and a specificity of 99.8 (95% CrI: 99.6, 100.0). Our results show variations in the prevalence point estimates related to all three factors investigated.


Our study illustrates that multiple data sources capture more RA cases and thus a higher prevalence estimate. RA point prevalence estimates using billing data are lower if few years of data are used.


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