Application and Validation of Case-Finding Algorithms for Identifying Individuals with Human Immunodeficiency Virus from Administrative Data in British Columbia, Canada

Nosyk, Bohdan; Colley, Guillaume; Yip, Benita; Chan, Keith; Heath, Katherine; Lima, Viviane D.; Gilbert, Mark; Hogg, Robert S.; Harrigan, P. Richard; Montaner, Julio S. G.
January 2013
PLoS ONE;Jan2013, Vol. 8 Issue 1, Special section p1
Academic Journal
Objective: To define a population-level cohort of individuals infected with the human immunodeficiency virus (HIV) in the province of British Columbia from available registries and administrative datasets using a validated case-finding algorithm. Methods: Individuals were identified for possible cohort inclusion from the BC Centre for Excellence in HIV/AIDS (CfE) drug treatment program (antiretroviral therapy) and laboratory testing datasets (plasma viral load (pVL) and CD4 diagnostic test results), the BC Centre for Disease Control (CDC) provincial HIV surveillance database (positive HIV tests), as well as databases held by the BC Ministry of Health (MoH); the Discharge Abstract Database (hospitalizations), the Medical Services Plan (physician billing) and PharmaNet databases (additional HIV-related medications). A validated case-finding algorithm was applied to distinguish true HIV cases from those likely to have been misclassified. The sensitivity of the algorithms was assessed as the proportion of confirmed cases (those with records in the CfE, CDC and MoH databases) positively identified by each algorithm. A priori hypotheses were generated and tested to verify excluded cases. Results: A total of 25,673 individuals were identified as having at least one HIV-related health record. Among 9,454 unconfirmed cases, the selected case-finding algorithm identified 849 individuals believed to be HIV-positive. The sensitivity of this algorithm among confirmed cases was 88%. Those excluded from the cohort were more likely to be female (44.4% vs. 22.5%; p<0.01), had a lower mortality rate (2.18 per 100 person years (100PY) vs. 3.14/100PY; p<0.01), and had lower median rates of health service utilization (days of medications dispensed: 9745/100PY vs. 10266/100PY; p<0.01; days of inpatient care: 29/100PY vs. 98/100PY; p<0.01; physician billings: 602/100PY vs. 2,056/100PY; p<0.01). Conclusions: The application of validated case-finding algorithms and subsequent hypothesis testing provided a strong framework for defining a population-level cohort of HIV infected people in BC using administrative databases.


Related Articles

  • Hope and hype.  // Network Magazine of the Canadian Women's Health Network;Winter1998/1999, Vol. 2 Issue 1, p3 

    Relates how the author decided to go on combination therapy to combat HIV-related symptoms. Author's initial refusal to take any AIDS drugs; Details of how the author reached the decision to try a combination of AIDS drugs; Author's daily medication routine; Effects of the combination therapy.

  • Patient Adherence To HAART Regimens: Challenges For Physician Assistants And Health Care Providers. Day, Marvin // Internet Journal of Academic Physician Assistants;2003, Vol. 3 Issue 1, p42 

    Patients often adhere incompletely and inadequately to highly active antiretroviral therapy (HAART) regimens used in the treatment of HIV infection. This permits the emergence of HIV variants that are resistant to current treatment. The physician assistant often assumes the responsibility for...

  • Comparative Cost-Efficacy Analysis of Darunavir/ritonavir and Other Ritonavir-Boosted Protease Inhibitors for First-Line Treatment of HIV-1 Infection in the United States. Brogan, Anita J.; Mrus, Joseph; Hill, Andrew; Sawyer, Anthony W.; Smets, Erik // HIV Clinical Trials;May/Jun2010, Vol. 11 Issue 3, p133 

    Purpose: A comprehensive study comparing the costs and efficacies of darunavir/ritonavir 800/100 mg qd and the other ritonavir-boosted (/r) protease inhibitors (PIs) recommended for treatment-naïve individuals with HIV-1 infection would help health care decision makers identify the value of...

  • HAART INCREASES LONGEVITY.  // AIDS Patient Care & STDs;Jun2000, Vol. 14 Issue 6, p336 

    Reports on the effectiveness of highly active antiretrovial therapy in reducing mortality risk among HIV patients in Europe. Age groups who obtained the most benefit from therapy; Survival rates by age groups.

  • Are All Subtypes Created Equal? The Effectiveness of Antiretroviral Therapy against Non-Subtype B HIV-1. Pond, Sergei L. Kosakovsky; Smith, Davey M. // Clinical Infectious Diseases;5/1/2009, Vol. 48 Issue 9, p1306 

    The article reports on the study regarding the effectiveness of modern combination of antiretroviral therapy against non-subtype B HIV-1 in the U.S. It states that the study examined the rates of viral suppression with antiretroviral therapy during infection with subtypes A, C, and D and with...

  • Phase II Study of Vicriviroc versus Efavirenz (both with Zidovudine/Lamivudine) in Treatment-Naive Subjects with HIV-1 Infection. Landovitz, Raphael J.; Angel, Jonathan B.; Hoffmann, Christian; Horst, Heinz; Opravil, Milos; Long, Jianmin; Greaves, Wayne; Fätkenheuer, Gerd // Journal of Infectious Diseases;10/15/2008, Vol. 198 Issue 8, p1113 

    Background. Vicriviroc (VCV) is a CCR5 antagonist with nanomolar activity against human immunodeficiency virus (HIV) replication in vitro and in vivo. We report the results of a phase II dose-finding study of VCV plus dual nucleoside reverse-transcriptase inhibitors (NRTIs) in the...

  • Triple-combination rilpivirine, emtricitabine, and tenofovir (Complera/Eviplera) in the treatment of HIV infection. Bernardini, Claudia; Maggiolo, Franco // Patient Preference & Adherence;2013, Vol. 7, p531 

    The combination rilpivirine (RPV)/emtricitabine (FTC)/tenofovir (TDF) is a oncedaily, single-tablet regimen (STR) containing one nonnucleoside reverse-transcriptase inhibitor associated with two nucleos(t)ide reverse transcriptase inhibitors. It is approved by regulatory agencies (eg, US Food...

  • Immune recovery among HIV-infected patients in northwestern Tanzania after 2 years of anti-retroviral therapy use: a retrospective cohort study. MPONDO, BONAVENTURA C. T.; KABANGILA, RODRICK; EPHRAIM, LUCHERI; ERNEST, ALEX; KIDENYA, BENSON R. // Tanzania Journal of Health Research;Oct2015, Vol. 17 Issue 4, p1 

    Background: The use of antiretroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) is associated with significant and sustained decrease in the viral RNA levels that allows the immune system to recover. The extent of this immune recovery depends on the baseline CD4...

  • The risk of AIDS-defining events is decreasing over time in the German HIV-1 Seroconverter Cohort. Altmann, Mathias; an der Heiden, Matthias; Scheufele, Ramona; Hartmann, Katrin; Houareau, Claudia; Bartmeyer, Barbara; Hamouda, Osamah // BMC Infectious Diseases;2012, Vol. 12 Issue 1, p94 

    Background: With ageing of the HIV-infected population, long-term exposure to treatment, varying adherence, emerging resistance and complications to therapies, effectiveness of Highly Active Antiretroviral Therapy (HAART) needs to be monitored continuously at the population level. The German...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics