Key result
Using a 10-year look-back period in hospital administrative data reduced the risk of misclassifying recurrent stroke as incident to less than 1%, compared to 10% with a 1-year look-back period.
Why the study?
What length of look-back period in administrative data is required to minimize misclassification of incident and recurrent strokes?
Observational (n=8,364)
Yes
What length of look-back period in administrative data is required to minimize misclassification of incident and recurrent strokes?
A 10-year look-back period in hospital administrative data is necessary to accurately distinguish recurrent from incident stroke, minimizing misclassification to less than 1%.
Supports extended look-back in administrative data for accurate stroke classification; leaves open optimal duration across datasets.
BACKGROUND/AIMS: Administrative data are widely used to monitor epidemiological trends in stroke and outcomes; yet there is scant empirical guidance on how to best differentiate incident from recurrent stroke. METHODS: We identified all hospital admissions in New South Wales, Australia, with a principal stroke diagnosis from July 1, 2013 to June 30, 2014, linked to 12 years of previous admissions. We calculated the proportion of cases identified with a prior stroke to determine the number of years of look-back required to minimise misclassification of incident and recurrent strokes. RESULTS: Using the maximum available look-back period of 12 years, 1,171 out of 8,364 eligible stroke cases (14.0%) had a stroke history. A 1-year look-back period identified only 25.1% of these patients and 1 in 10 stroke cases were misclassified as incident. With a 10-year clearance period, less than 1 in 100 stroke cases were misclassified as incident. The risk of misclassification was lower in patients younger than 65 years and in those with haemorrhagic stroke. CONCLUSION: Hospital administrative data sets linked to prior admissions can be used to distinguish recurrent from incident stroke. The risk of misclassifying recurrent stroke cases as incident events is negligible with a look-back period of 10 years.
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Worthington et al. (2017) conducted an observational in Stroke (n=8,364). 10-year look-back period vs. 1-year look-back period was evaluated on Proportion of cases identified with a prior stroke to minimize misclassification of incident and recurrent strokes. Using a 10-year look-back period in hospital administrative data reduced the risk of misclassifying recurrent stroke as incident to less than 1%, compared to 10% with a 1-year look-back period.
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