Algorithmic approach to finding people with multiple sclerosis using routine healthcare data in Wales

J Neurol Neurosurg Psychiatry. 2024 Oct 16;95(11):1032-1035. doi: 10.1136/jnnp-2024-333532.

Abstract

Background: Identification of multiple sclerosis (MS) cases in routine healthcare data repositories remains challenging. MS can have a protracted diagnostic process and is rarely identified as a primary reason for admission to the hospital. Difficulties in identification are compounded in systems that do not include insurance or payer information concerning drug treatments or non-notifiable disease.

Aim: To develop an algorithm to reliably identify MS cases within a national health data bank.

Method: Retrospective analysis of the Secure Anonymised Information Linkage (SAIL) databank was used to identify MS cases using a novel algorithm. Sensitivity and specificity were tested using two existing independent MS datasets, one clinically validated and population-based and a second from a self-registered MS national registry.

Results: From 4 757 428 records, the algorithm identified 6194 living cases of MS within Wales on 31 December 2020 (prevalence 221.65 (95% CI 216.17 to 227.24) per 100 000). Case-finding sensitivity and specificity were 96.8% and 99.9% for the clinically validated population-based cohort and sensitivity was 96.7% for the self-declared registry population.

Discussion: The algorithm successfully identified MS cases within the SAIL databank with high sensitivity and specificity, verified by two independent populations and has important utility in large-scale epidemiological studies of MS.

Keywords: EPIDEMIOLOGY; MULTIPLE SCLEROSIS.

MeSH terms

  • Adult
  • Algorithms*
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis* / diagnosis
  • Multiple Sclerosis* / epidemiology
  • Prevalence
  • Registries*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Wales / epidemiology