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Neurology
Protocol
Accuracy and utility of using administrative healthcare databases to identify people with epilepsy: a protocol for a systematic review and meta-analysis
  1. Gashirai K Mbizvo1,2,
  2. Kyle Bennett1,
  3. Colin R Simpson3,4,
  4. Susan E Duncan1,2,
  5. Richard F M Chin1,5
  1. 1 Muir Maxwell Epilepsy Centre, University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
  2. 2 Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
  3. 3 Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
  4. 4 Usher Institute of Population Health Sciences and Informatics, University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
  5. 5 Department of Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
  1. Correspondence to Dr Gashirai K Mbizvo; gashirai.mbizvo{at}ed.ac.uk

Abstract

Introduction In an increasingly digital age for healthcare around the world, administrative data have become rich and accessible tools for potentially identifying and monitoring population trends in diseases including epilepsy. However, it remains unclear (1) how accurate administrative data are at identifying epilepsy within a population and (2) the optimal algorithms needed for administrative data to correctly identify people with epilepsy within a population. To address this knowledge gap, we will conduct a novel systematic review of all identified studies validating administrative healthcare data in epilepsy identification. We provide here a protocol that will outline the methods and analyses planned for the systematic review.

Methods and analysis The systematic review described in this protocol will be conducted to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE and Embase will be searched for studies validating administrative data in epilepsy published from 1975 to current (01 June 2018). Included studies will validate the International Classification of Disease (ICD), Ninth Revision (ICD-9) onwards (ie, ICD-9 code 345 and ICD-10 codes G40–G41) as well as other non-ICD disease classification systems used, such as Read Codes in the UK. The primary outcome will be providing pooled estimates of accuracy for identifying epilepsy within the administrative databases validated using sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curves. Heterogeneity will be assessed using the I2 statistic and descriptive analyses used where this is present. The secondary outcome will be the optimal administrative data algorithms for correctly identifying epilepsy. These will be identified using multivariable logistic regression models. 95% confidence intervals will be quoted throughout. We will make an assessment of risk of bias, quality of evidence, and completeness of reporting for included studies.

Ethics and dissemination Ethical approval is not required as primary data will not be collected. Results will be disseminated in peer-reviewed journals, conference presentations and in press releases.

PROSPERO registration CRD42017081212.

  • epilepsy
  • factual database
  • administrative claims
  • algorithms
  • validation studies

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-020824

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    Footnotes

    • Contributors GKM and RFMC conceived the idea for the protocol and made the main contribution to planning and preparation of timelines for its completion. GKM and KB put together and tested various search strategies for the protocol and, after consultation with CRS, had these reviewed and approved by Marshall Dozier at the University of Edinburgh library whose support we acknowledge. GKM and RFMC planned the data extraction and statistical analysis, as well as of risk of bias, quality of evidence and completeness of reporting assessments. GKM designed the tables and wrote the first draft of the manuscript, which was then reviewed and amended by KB, CRS, SED and RFMC. All authors then approved the final written manuscript. RFMC is the guarantor for the work.

    • Funding This work was supported by Epilepsy Research UK (R44007) and the Juliet Bergqvist Memorial Fund.

    • Disclaimer The funders had no role in the design of the protocol, its preparation, analyses, interpretation of the data, manuscript preparation or decision to submit.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Author note Any future amendments of the protocol will be listed in this section along with a date, description, and rational for each amendment.