What is the ‘real’ admission rate of acute pancreatitis in a regional Australian population?
Richard C. Turner A D , Katina D’Onise B and Yan Wang CA School of Medicine, University of Tasmania, Private Bag 96, Hobart, Tas. 7001, Australia.
B School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA 5001, Australia. Email: katina.d’onise@unisa.edu.au
C School of Mathematical and Geospatial Sciences, RMIT University, GPO Box 2476V, Melbourne, Vic. 3001, Australia. Email: yan.wang@rmit.edu.au
D Corresponding author. Email: richard.turner@utas.edu.au
Australian Health Review 37(2) 205-209 https://doi.org/10.1071/AH12174
Submitted: 24 April 2012 Accepted: 4 October 2012 Published: 18 March 2013
Abstract
Objective. Capture-recapture analysis was used to more accurately quantify the admission rate for acute pancreatitis in a regional hospital setting, in comparison to the usual method of case ascertainment. Reasons for differences in capture for the various methods were also sought.
Methods. Admissions for acute pancreatitis were enumerated over a 40-month period using three data sources: hospital classification of admission diagnoses, prospective case identification, and receipt of diagnosis-specific pathology specimens. Capture-recapture analysis was applied with log-linear modelling to account for likely dependency between data sources. Covariates were noted to explain capture probability by the various data sources and for eventual stratification in the analysis process.
Results. For the census period, there were 304 admissions after merging of data sources, giving a crude admission rate of 7.6 per month. Crude ascertainment rates for discharge records and prospective identification were 44% and 52% respectively. Following log-linear modelling, total admissions more than doubled to 644 (adjusted admission rate 16.1 per month). Of the covariates considered, admissions of less than three days’ duration and those occurring in December and January were significantly associated with increased capture by the hospital discharge records data source.
Conclusions. In this clinical setting, admissions for acute pancreatitis are grossly underestimated by the standard case ascertainment method. The reasons for this are not clear. Hospital discharge records are nevertheless more effective than prospective case ascertainment for certain cases, such as brief admissions and those in holiday periods.
What is known about the topic? Capture–recapture analysis was originally developed in animal ecology, but has since been used to estimate both prevalent and incident cases of human disease.
What does this paper add? This study exposes possible deficiencies in the single-source case ascertainment methods used by most hospitals to enumerate incident cases. It is the first time that capture–recapture techniques have been used to estimate acute pancreatitis admissions.
What are the implications for practitioners? To obtain accurate admissions estimates for diseases such as acute pancreatitis, capture–recapture analysis with multiple data sources is advisable. One possible solution may be to conduct intermittent prospective censuses to complement existing retrospective ascertainment methods. On a more general level, clinical staff should be better trained to provide more accurate and detailed information in case records.
References
[1] Appelros S, Borgström A. Incidence, aetiology and mortality rate of acute pancreatitis over 10 years in a defined population in Sweden. Br J Surg 1999; 86 465–70.| Incidence, aetiology and mortality rate of acute pancreatitis over 10 years in a defined population in Sweden.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3jtlOlsg%3D%3D&md5=58213789e07222d38d0d4c687e68cb3aCAS |
[2] Tilling K. Capture–recapture methods - useful or misleading? Int J Epidemiol 2001; 30 12–4.
| Capture–recapture methods - useful or misleading?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvgvVGhtg%3D%3D&md5=0fdfef4d83c3247a1ca38133bb458c34CAS |
[3] Ah-Tye PJ. Pancreatitis in remote Australia: an indigenous perspective. Aust J Rural Health 2001; 9 134–7.
| Pancreatitis in remote Australia: an indigenous perspective.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2Fhs1GgsQ%3D%3D&md5=ce3cc14b5f481aeeb55f99ad77df75b7CAS |
[4] Smith GS, Langlois JA, Beuchner JS. Methodological issues in using hospital discharge data to determine the incidence of hospitalized injuries. Am J Epidemiol 1991; 134 1146–58.
| 1:STN:280:DyaK38%2FotFOgsQ%3D%3D&md5=189da24c42f2facff6022789c97346e9CAS |
[5] Langley J, Stephenson S, Cryer C, Boman B. Traps for the unwary in estimating person based injury incidence using hospital discharge data. Inj Prev 2002; 8 332–7.
| Traps for the unwary in estimating person based injury incidence using hospital discharge data.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38jjvVWqug%3D%3D&md5=acbb039452d33445250f1e2bd4e3b218CAS |
[6] Chao A, Tsay PK, Lin SH, Shau WY, Chao DY. The applications of capture–recapture models to epidemiological data. Stat Med 2001; 20 3123–57.
| The applications of capture–recapture models to epidemiological data.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrksVWrsg%3D%3D&md5=a4a3a1d9c01e6a4fb166ee3d5aae0804CAS |
[7] Le Cren ED. A note on the history of mark–recapture population estimates. J Anim Ecol 1965; 34 453–4.
| A note on the history of mark–recapture population estimates.Crossref | GoogleScholarGoogle Scholar |
[8] Carter KL, Williams G, Tallo V, Sanvictores D, Madera H, Riley I. Capture–recapture analysis of all-cause mortality data in Bohol, Philippines. Popul Health Metr 2011; 9
| Capture–recapture analysis of all-cause mortality data in Bohol, Philippines.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXjtFOmsr0%3D&md5=d6fe4237727b376a7fb27f9b13f84ee0CAS |
[9] Schober E, Schneider U, Waldhör T, Tuomilehto J. Increasing incidence of IDDM in Austrian children: a nationwide study 1979–1993. Diabetes Care 1995; 18 1280–3.
| Increasing incidence of IDDM in Austrian children: a nationwide study 1979–1993.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK287pt1Chug%3D%3D&md5=dc5db19f63a8a06df21e279d200c9cb6CAS |
[10] Morris AD, Boyle DIR, MacAlpine R, Emslie-Smith A, Jung RT, Newton RW, et al The diabetes audit and research in Tayside Scotland (DARTS) study: electronic record linkage to create a diabetes register. BMJ 1997; 315 524–8.
| The diabetes audit and research in Tayside Scotland (DARTS) study: electronic record linkage to create a diabetes register.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svmvFyqsA%3D%3D&md5=6a26c2864bc95125d110b8de9eed82faCAS |
[11] Berger B, Stenson G, Chang YF, Sundkvist G. The prevalence of diabetes in a Swedish population of 280,441 inhabitants: a report from the Skaraborg diabetes registry. Diabetes Care 1998; 21 546–8.
| The prevalence of diabetes in a Swedish population of 280,441 inhabitants: a report from the Skaraborg diabetes registry.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3jt1ygsw%3D%3D&md5=f927f509b5e1ca8613de50ac131bd67eCAS |
[12] Robles SC, Marret LD, Clarke EA, Risch HA. An application of capture recapture methods to the estimation of completeness of cancer registration. J Clin Epidemiol 1988; 135 1060–7.
[13] Schouten LJ, Straatman H, Kiemeney LA, Gimbrère CH, Verbeek AL. The capture–recapture method for estimation of cancer registry completeness: a useful tool? Int J Epidemiol 1994; 23 1111–1116.
| The capture–recapture method for estimation of cancer registry completeness: a useful tool?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M3jvVSltg%3D%3D&md5=8f8ba6916ab8c7f68aa3859dc176b6dbCAS |
[14] Dockerty JD, Becroft DMO, Lewis ME. The accuracy and completeness of childhood cancer registration in New Zealand. Cancer Causes Control 1997; 8 857–64.
| The accuracy and completeness of childhood cancer registration in New Zealand.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c%2Foslejsg%3D%3D&md5=c36660a5af5b142f899dc34628bf7288CAS |
[15] Kim DS, Lee MS, Kim DH, Bae JM, Shin MH, Lee CM, et al Evaluation of the completeness of cancer case ascertainment in the Seoul male cohort study: application of the capture–recapture method. J Epidemiol 1999; 9 146–54.
| Evaluation of the completeness of cancer case ascertainment in the Seoul male cohort study: application of the capture–recapture method.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MzktVOntg%3D%3D&md5=be684ea0b86da6f197fc7dfdc66d211aCAS |
[16] Abeni DD, Brancato G, Perucci CA. Capture-recapture to estimate the size of the population with human immunodeficiency virus type 1 infection. Epidemiology 1994; 5 410–4.
| Capture-recapture to estimate the size of the population with human immunodeficiency virus type 1 infection.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M%2Fgt1ensg%3D%3D&md5=82c0cd2acd3a78c02e2f208114610d14CAS |
[17] Mastro TD, Kitayaporn D, Weniger BG, Vanichseni S, Laosunthorn V, Uneklabh C, et al Estimating the number of HIV-infected drug users in Bangkok: a capture–recapture method. Am J Public Health 1994; 84 1094–9.
| Estimating the number of HIV-infected drug users in Bangkok: a capture–recapture method.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c3ovVWltg%3D%3D&md5=36485db5d64edc05ac359fbb73cc6e13CAS |
[18] Tilling K. Estimation of the incidence of stroke using a capture–recapture model including covariates. Int J Epidemiol 2001; 30 1351–9.
| Estimation of the incidence of stroke using a capture–recapture model including covariates.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2Fpt1ansg%3D%3D&md5=ba621c8d211cbf379b8fe0c82b2f50b6CAS |
[19] Morrison A, Stone DH. Capture–recapture: a useful methodological tool for counting traffic related injuries? Inj Prev 2000; 6 299–304.
| Capture–recapture: a useful methodological tool for counting traffic related injuries?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7ksV2jtg%3D%3D&md5=d3f8892614620d48373baea35140c7ffCAS |
[20] Ponzio M, Perotti PG, Monti MC, Montomoli C, San Bartolomeo P, Iannello G, et al Prevalence estimates of alcohol related problems in an area of northern Italy using the capture–recapture method. Eur J Public Health 2010; 20 576–81.
| Prevalence estimates of alcohol related problems in an area of northern Italy using the capture–recapture method.Crossref | GoogleScholarGoogle Scholar |
[21] Toouli J, Brooke-Smith M, Bassi C, Carr-Locke D, Telford J, Freeney P, et al Working party report: guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol 2002; 17 S15–39.
| Working party report: guidelines for the management of acute pancreatitis.Crossref | GoogleScholarGoogle Scholar |
[22] Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr 1974; 19 716–23.
| A new look at the statistical model identification.Crossref | GoogleScholarGoogle Scholar |
[23] Regal RR,, Hook EB. Goodness-of-fit confidence intervals for estimates of the size of a closed population. Stat Med 1984; 3 287–91.
| Goodness-of-fit confidence intervals for estimates of the size of a closed population.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL2M%2Fhs1aisw%3D%3D&md5=90858135a1bb8598566b49717b05c3f0CAS |
[24] Duckett S. Casemix funding for acute hospital inpatient services in Australia. Med J Aust 1998; 169 S17–21.
[25] Best AE. Secondary data bases and their use in outcomes research: a review of the area resource file and the healthcare cost and utilization project. J Med Syst 1999; 23 175–81.
| Secondary data bases and their use in outcomes research: a review of the area resource file and the healthcare cost and utilization project.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2Fit1ertg%3D%3D&md5=5f9b7f360a5b3aac7f59c425e6dfa01aCAS |
[26] Penberthy L, McClish D, Pugh A, Smith W, Manning C, Retchin S. Using hospital discharge files to enhance cancer surveillance. Am J Epidemiol 2003; 158 27–34.
| Using hospital discharge files to enhance cancer surveillance.Crossref | GoogleScholarGoogle Scholar |
[27] Regal RR, Hook EB. Capture–recapture methods in epidemiology: methods and limitations. Epidemiol Rev 1995; 17 243–64.
[28] Fienberg SE. The multiple recapture census for closed populations and incomplete 2K contingency tables. Biometrika 1972; 59 591–603.
[29] International Working Group for Disease Monitoring and Forecasting Capture–recapture and multiple record systems estimation II: applications in human diseases. Am J Epidemiol 1995; 142 1059–68.
[30] Bruno G, LaPorte RE, Merletti F, Biggeri A, McCarty D, Pagano G. National diabetes programs: Application of capture–recapture to count diabetes? Diabetes Care 1994; 17 548–56.
| National diabetes programs: Application of capture–recapture to count diabetes?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2czmsVWmtQ%3D%3D&md5=9d2ef6eff43f325da96689754b704f05CAS |
[31] Ismail AA, Beeching NJ, Gill GV, Bellis MA. Capture–recapture-adjusted prevalence rates of type 2 diabetes are related to social deprivation. Q J Med 1999; 92 707–10.
| Capture–recapture-adjusted prevalence rates of type 2 diabetes are related to social deprivation.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c7htlSqsQ%3D%3D&md5=841c08340b79318171dfdc075c374667CAS |
[32] Gill GV, Ismail AA, Beeching NJ, Macfarlane SBJ, Bellis MA. Hidden diabetes in the UK: use of capture–recapture methods to estimate total prevalence of diabetes mellitus in an urban population. J R Soc Med 2003; 96 328–32.
| Hidden diabetes in the UK: use of capture–recapture methods to estimate total prevalence of diabetes mellitus in an urban population.Crossref | GoogleScholarGoogle Scholar |
[33] Cormack RM. (1981). Log-linear models for capture–recapture experiments on open populations. In: Hiorns RW, Cooke D, editors. The mathematical theory of the dynamics of biological populations II. London: Academic Press; 1981. pp 217–235.
