Differing Definitions of First-Ever Stroke Influence Incidence Estimates More Than Trends: A Study Using Linked Administrative Data

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aut.relation.journalNeuroepidemiology
dc.contributor.authorYouens, David
dc.contributor.authorKatzenellenbogen, Judith
dc.contributor.authorSrinivasa Ragavan, Rathina
dc.contributor.authorSodhi-Berry, Nita
dc.contributor.authorCarson, Jennie
dc.contributor.authorZemedikun, Dawit
dc.contributor.authorThrift, Amanda G
dc.contributor.authorFeigin, Valery
dc.contributor.authorNedkoff, Lee
dc.date.accessioned2023-11-23T22:26:23Z
dc.date.available2023-11-23T22:26:23Z
dc.date.issued2023-09-26
dc.description.abstractIntroduction Researchers apply varying definitions when measuring stroke incidence using administrative data. We aimed to investigate the sensitivity of incidence estimates to varying definitions of stroke and lookback periods, and to provide updated incidence rates and trends for Western Australia (WA). Methods We used linked state-wide hospital and death data from 1985-2017 to identify incident strokes from 2005-2017. A standard definition was applied which included strokes coded as the principal hospital diagnosis or the underlying cause of death, with a 10-year lookback used to clear prevalent cases. Alternative definitions were compared against the standard definition by percentage difference in case numbers. Age-standardised incidence rates were calculated, and age- and sex-adjusted Poisson regression models used to estimate incidence trends. Results The standard definition with a 10-year lookback period captured 31,274 incident strokes. Capture increased by 19.3% when including secondary diagnoses, 4.1% when including nontraumatic subdural and extradural haemorrhage, and 8.1% when including associated causes of death. Excluding death records reduced capture by 11.1%. A 20-year lookback reduced over-ascertainment by 2.0% and a 1-year lookback increased capture by 13.3%. Incidence declined 0.6% annually (95% confidence interval -0.9, -0.3). Annual reductions were similar for most definitions except when death records were excluded (-0.1%, CI -0.4, 0.2) and with the shortest lookback periods (greatest annual reduction). Conclusion Stroke incidence has declined in WA. Differing methods of identifying stroke influence estimates of incidence to a greater extent than estimates of trends. Reductions in stroke incidence over time are primarily driven by declines in hospitalised stroke.
dc.identifier.citationNeuroepidemiology, ISSN: 1423-0208 (Print); 1423-0208 (Online), S. Karger AG. doi: 10.1159/000534242
dc.identifier.doi10.1159/000534242
dc.identifier.issn1423-0208
dc.identifier.issn1423-0208
dc.identifier.urihttp://hdl.handle.net/10292/17001
dc.languageeng
dc.publisherS. Karger AG
dc.relation.urihttps://karger.com/ned/article/doi/10.1159/000534242/863406/Differing-Definitions-of-First-Ever-Stroke
dc.rights© 2023 The Author(s). Published by S. Karger AG, Basel. Open Access License / Drug Dosage / Disclaimer. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0
dc.subject4206 Public Health
dc.subject42 Health Sciences
dc.subjectStroke
dc.subjectBrain Disorders
dc.subject2.4 Surveillance and distribution
dc.subject2 Aetiology
dc.subjectStroke
dc.subject1109 Neurosciences
dc.subject1117 Public Health and Health Services
dc.subjectEpidemiology
dc.subject3202 Clinical sciences
dc.subject3209 Neurosciences
dc.subject4202 Epidemiology
dc.titleDiffering Definitions of First-Ever Stroke Influence Incidence Estimates More Than Trends: A Study Using Linked Administrative Data
dc.typeJournal Article
pubs.elements-id525164
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