Table 3.
Validity of dementia diagnoses in the UPDB administrative databases using CCSMHA diagnoses as the gold standard
| Alzheimer’s Disease/Alzheimer’s Disease Mixed | |||||
|---|---|---|---|---|---|
|
| |||||
| Statistics | Overall UPDB vs CCSMHA | AS vs CCSMHA | IC vs CCSMHA | DC vs CCSMHA* | Medicare vs CCSMHA |
| n (%) | 609 (12%) vs 628 (13%) | 19 (0.3%) vs 628 (13%) | 208 (4%) vs 628 (13%) | 193 (5%) vs 615 (15%) | 512 (10%) vs 628 (13%) |
| Sensitivity | 47.9 | 1.9 | 18.0 | 19.2 | 39.5 |
| Specificity | 93.0 | 99.8 | 97.8 | 97.9 | 94.0 |
| PPV | 49.4 | 63.2 | 54.3 | 61.1 | 48.4 |
| NPV | 92.6 | 87.7 | 89.3 | 87.6 | 91.6 |
| AUC | 0.70 | 0.51 | 0.58 | 0.59 | 0.67 |
| Cohen’s k | 0.41 | 0.03 | 0.22 | 0.24 | 0.36 |
| Related Dementias | |||||
|
| |||||
| Statistics | Overall UPDB vs CCSMHA | AS vs CCSMHA | IC vs CCSMHA | DC vs CCSMHA* | Medicare vs CCSMHA |
|
| |||||
| n (%) | 832 (17%) vs 300 (6%) | 17 (<0.1%) vs 300 (6%) | 317 (6%) vs 300 (6%) | 236 (6%) vs 298 (7%) | 595 (12%) vs 300 (6%) |
| Sensitivity | 35.7 | 0.003 | 14.7 | 19.1 | 25.7 |
| Specificity | 84.6 | 99.7 | 94.2 | 95.4 | 89.0 |
| PPV | 12.9 | 5.8 | 13.9 | 24.2 | 12.9 |
| NPV | 95.4 | 94.0 | 94.6 | 93.9 | 95.0 |
| AUC | 0.60 | 0.50 | 0.54 | 0.57 | 0.57 |
| Cohen’s k | 0.11 | 0.001 | 0.09 | 0.16 | 0.10 |
| All-Cause Dementia | |||||
|
| |||||
| Statistics | Overall UPDB vs CCSMHA | AS vs CCSMHA | IC vs CCSMHA | DC vs CCSMHA* | Medicare vs CCSMHA |
|
| |||||
| N (%) | 1441 (29%) vs 928 (19%) | 36 (1%) vs 928 (19%) | 525 (11%) vs 928 (19%) | 429 (10%) vs 913 (22%) | 1107 (22%) vs 928 (19%) |
| Sensitivity | 71.0 | 2.4 | 30.2 | 30.2 | 57.1 |
| Specificity | 80.9 | 99.7 | 94.0 | 95.3 | 85.9 |
| PPV | 45.7 | 61.1 | 53.3 | 64.1 | 47.9 |
| NPV | 92.5 | 81.8 | 85.6 | 83.0 | 89.8 |
| AUC | 0.76 | 0.51 | 0.62 | 0.63 | 0.71 |
| Cohen’s k | 0.43 | 0.03 | 0.29 | 0.31 | 0.40 |
AS: Ambulatory (Outpatient) Surgery; AUC: Area Under the Curve; CCSMHA: Cache County Study of Memory, Health, and Aging; Cohen’s k=Cohen’s Kappa Coefficient; DC: Death Certificates; IC: Inpatient Hospital Claims; NPV: Negative Predictive Value; PPV: Positive Predictive Value; UPDB: Utah Population Database
*
Among only those who are deceased. κ between 0.00 and 0.20 indicates slight agreement; κ between 0.21 and 0.40 denotes fair agreement; κ between 0.41 and 0.60 characterizes moderate agreement; κ between 0.61 and 0.80 defines substantial agreement and a value of κ greater than 0.80 equates to almost perfect agreement.