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about institute for clinical evaluative sciences (ICES) cerebrovascular disease data

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

Data SOURCE

Original source: Ontario Health Insurance Plan (OHIP) Claims Database, Discharge Abstract Database (DAD)
Distributed by: Institute for Clinical Evaluative Sciences (ICES)
Cite as: OHIP Claims Database (OHIP) and Discharge Abstract Database (DAD), 1996-2015, Institute for Clinical Evaluative Sciences (ICES) [Data provided by special request, May, 2017].

METHODS

Data Collection Methods

ICES use data from the following databases to make a determination of cerebrovascular disease prevalence and incidence:

  • Ontario Health Insurance Plan (OHIP) Claims Database – The OHIP database contains approved physician claims data from inpatient, outpatient and long-term care settings for physicians in Ontario. Among other information, each record identifies the physician, the patient, the diagnosis responsible for the claim (which follows the ICD-9 coding scheme), the service provided and the date of service.
  • Discharge Abstract Database (DAD) – The DAD summarizes the hospital discharge information of individuals receiving inpatient care in a non-mental health designated bed. Each record contains demographic, clinical and administrative data regarding the hospitalized individual, including the diagnosis most responsible for the hospitalization (which follows the ICD-9 coding scheme before 2002 and the ICD-10 scheme from 2002 onwards), as well as comorbidities and procedures received.
  • Registered Persons Database (RPDB) – The RPDB contains demographic information such as age, sex, health insurance eligibility and death information for anyone who has received Ontario health care coverage. It contains postal code information that is linkable to other geographic information such as public health unit.
  • Canadian Census 2011 – This database contains information from the 2011 Canadian Census including population counts.
  • Yearly Ontario intercensal and postcensal population estimates and projections – This database contains yearly estimates of the Ontario population, overall and by smaller geographical units such as public health units, as measured on July 1 of each year.

Cerebrovascular disease (CVD) cases were defined as individuals with at least one cerebrovascular disease record in the DAD (diagnostic or procedure code) or two cerebrovascular disease records within a one-year period in OHIP (note: the first OHIP visit date was selected of the two that met the criteria as the diagnosis date). The following codes were used to define cerebrovascular disease:

OHIP CODES
ICD-9 (diagnostic code) ICD Code name
432 Other and unspecified intracranial hemorrhage
436 Acute, but ill-defined, cerebrovascular disease

DAD
ICD-9 ICD Code name
430 Subarachnoid hemorrhage
431 Intracerebral hemorrhage
434 Occlusion of cerebral arteries
436 Acute, but ill-defined, cerebrovascular disease

ICD-10 ICD Code name
H34.0 Retinal vascular occlusions
H34.1 Central retinal artery occlusion
I60.0 Subarachnoid haemorrhage from carotid siphon and bifurcation
I60.1 Subarachnoid haemorrhage from middle cerebral artery
I60.2 Subarachnoid haemorrhage from anterior communicating artery
I60.3 Subarachnoid haemorrhage from posterior communicating artery
I60.4 Subarachnoid haemorrhage from basilar artery
I60.5 Subarachnoid haemorrhage from vertebral artery
I60.6 Subarachnoid haemorrhage from other intracranial arteries
I60.7 Subarachnoid haemorrhage from intracranial artery, unspecified
I60.9 Subarachnoid haemorrhage, unspecified
I61 Intracerebral haemorrhage
I63.0 Cerebral infarction due to thrombosis of precerebral arteries
I63.1 Cerebral infarction due to embolism of precerebral arteries
I63.2 Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
I63.3 Cerebral infarction due to thrombosis of cerebral arteries
I63.4 Cerebral infarction due to embolism of cerebral arteries
I63.5 Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
I63.8 Other cerebral infarction
I63.9 Cerebral infarction, unspecified
I64 Stroke, not specified as haemorrhage or infarction

CCP - Canadian Classification of
Diagnostic, Therapeutic and
Surgical Procedures (<2002)
CCP Code name
1IJ50 Dilation, coronary arteries
1IJ57GQ Extraction, coronary arteries
1IJ76 Bypass, coronary arteries

CCP - Canadian Classification of Diagnostic, Therapeutic and Surgical interventions (2002+) CCP Code name
48.02 Percutaneous transluminal coronary angioplasty (ptca) without mention of thrombolytic agent
48.03 Percutaneous transluminal coronary angioplasty (ptca) with thrombolytic agent
48.09 Other removal of coronary artery obstruction
48.1 Bypass anastomosis for heart revascularization

Data Analysis methods

  • Inclusion criteria: All individuals living in Ontario with cerebrovascular disease (CVD). Individuals were identified with the disease according to a CVD algorithm1 using diagnostic code information from OHIP and DAD. Individuals had to be 20 years and older but less than 106 years.
  • Exclusion criteria: Individuals were excluded if they did not have an Ontario postal code or did not have contact with the Ontario health care system within the past seven years.
  • Prevalence: The numerator was all individuals residing in the Region of Peel or Ontario, diagnosed with CVD since 1991. The denominator was all individuals living in the Region of Peel or Ontario (according to Ontario population estimates and projections). Total rates were age-sex-standardized and rates by sex were age-standardized to the 2011 Canadian Census population. Age-specific crude rates were also provided.
  • Incidence: For each year (January 1 to December 31) the numerator was all individuals residing in Region of Peel or Ontario who were newly identified in that year with CVD. The denominator was all individuals living in the Region of Peel or Ontario (according to Ontario population estimates and projections) that did not have CVD (i.e., the susceptible population). Total rates were age-sex-standardized and rates by sex were age-standardized to the 2011 Canadian Census population. Age-specific crude rates were also provided.
  • Cells less than or equal to 5 individuals are not reportable for privacy reasons, and appear in the tables as "NR" for "Not releasable due to small numbers".

LIMITATIONS

  • Currently, this data source only provides information at the Census Division (CD) or Public Health Unit (PHU) level of geography.

REFERENCES AND RESOURCES

  1. Tu K, Wang M, Young J, et al. Validity of administrative data for identifying patients who have had a stroke or transient ischemic attack using EMRALD as a reference standard. Can J Cardiol 2013; 29: 1388–94.

Last updated: February 12, 2019



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