Use of Single Data Source Can Significantly Underestimate Hepatitis C Mortality Rates

Slideset on:

Wu C, Chang HG, McNutt LA, Smith PF. Estimating the mortality rate of hepatitis C using multiple data sources. Epidemiol Infect. 2005;133:121-125.

clinicaloptions.com/hep

Estimating Mortality Rates of Hepatitis C

Background and Rationale

Hepatitis C major cause of liver disease in the US

– 3.9 million people infected with HCV in the US

– 75-85% develop chronic liver infection– Can lead to liver cirrhosis and hepatocellular carcinoma

– 8000-10,000 HCV-related deaths/year

Current study evaluated hepatitis C mortality rate in upstate New York

– Accuracy of hepatitis C coding in hospitals investigated

Wu C, et al. Epidemiol Infect. 2005;133:121-125.

clinicaloptions.com/hep

Estimating Mortality Rates of Hepatitis C

Summary of Study Design

Total number of hepatitis C-related deaths in New York State for 1997

– Not including New York City

New York State hospital discharge database

– All in-patient admissions into non-federal, non-psychiatric hospitals included

– Hepatitis C mortality: discharge coded as death from hepatitis C

New York State multiple cause-of-death file

– Hepatitis C mortality: death with hepatitis C on file as primary or secondary condition

Wu C, et al. Epidemiol Infect. 2005;133:121-125.

clinicaloptions.com/hep

Estimating Mortality Rates of Hepatitis C

Hepatitis C Mortality Rates

Hepatitis C Mortality Discharge Database Cause-of-Death Database

Number of deaths 158 87

Mortality rate (deaths/100,000 population) 1.4 0.8

Combined data using capture-recapture method

– Significantly higher estimate of mortality rate than either database alone

– 4.5 deaths/100,000 population; 95% CI, 3.2-5.7

– Males have higher mortality rate than females– Males: 6.1 deaths/100,000 population; 95% CI, 4.0-8.2

– Females: 2.9 deaths/100,000 population; 95% CI, 1.6-4.3

Wu C, et al. Epidemiol Infect. 2005;133:121-125.

clinicaloptions.com/hep

Estimating Mortality Rates of Hepatitis C

Key Conclusions

Single data sources drastically underestimate mortality rate from hepatitis C

Estimated more accurately by combining data from various sources

– Capture-recapture method successful at comparing data from different databases

Hepatitis C mortality rates are higher for men than women in New York state

Wu C, et al. Epidemiol Infect. 2005;133:121-125.