PO.PS01.05 · 人群科学
在患有2型糖尿病的男性退伍军人全国队列中对前列腺癌诊断和死因的验证
Validation of prostate cancer diagnosis and cause of death in a national cohort of male veterans with type 2 diabetes mellitus
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摘要 Abstract
中文摘要
背景：准确的诊断和死因判定对于有效的疾病监测、卫生规划和研究至关重要。本研究旨在验证患有2型糖尿病（T2DM）的退伍军人中前列腺癌（PCa）诊断的准确性及死因数据。
方法：我们开展了一项回顾性队列研究，纳入2010年至2019年间确诊为2型糖尿病（T2DM）的退伍军人，使用来自Veterans Health Administration（VHA）Corporate Data Warehouse（CDW）的数据。诊断编码和死因信息取自Prostate Cancer Data Core（PCDC）和National Death Index（NDI），后者作为验证CDW数据的金标准。使用Cohen's Kappa统计量评估各数据来源之间的一致性，并结合敏感性和特异性等诊断效能指标。
结果：在763,424名患有T2DM的退伍军人中，CDW中有37,048人诊断为PCa，PCDC中有36,861人，一致率为98.7%。NDI的死亡率数据显示，2,723例以PCa为根本死因的死亡，其中75.4%在CDW中有PCa诊断记录。就全因死亡率而言，CDW Vital Status File（VSF）中确认328,156名退伍军人死亡，NDI中报告326,707名死亡，两个来源之间的死亡一致率为99.3%。比较所有患者的新发PCa诊断，我们发现CDW具有高敏感性98.6%和特异性99.9%。同样，就特定死因死亡而言，敏感性为75.5%，特异性为100.0%。
结论：研究结果显示在关键关注结局上具有高度一致性，具体而言，CDW与PCDC之间的前列腺癌（PCa）诊断，以及CDW VSF与NDI数据来源之间的全因死亡率。鉴于从CDW检索和管理数据耗时较长，我们建议使用PCDC进行PCa诊断，使用CDW VSF进行全因死亡确认。
查看英文原文 English abstract
Background: Accurate diagnosis and determination of cause of death are essential for effective disease surveillance, health planning, and research. This study seeks to validate the diagnostic accuracy and cause of death data related to prostate cancer (PCa) among Veterans with type 2 diabetes mellitus (T2DM).
Methods : We conducted a retrospective cohort study of Veterans with type 2 diabetes (T2DM) diagnosed between 2010 and 2019, using data from the Veterans Health Administration (VHA) Corporate Data Warehouse (CDW). Diagnostic codes and cause of death information were obtained from the Prostate Cancer Data Core (PCDC) and the National Death Index (NDI), which served as the gold standard for validating CDW data. Concordance between data sources was evaluated using Cohen's Kappa statistic, along with measures of diagnostic performance such as sensitivity and specificity.
Result: Among 763,424 Veterans with T2DM, 37,048 were diagnosed with PCa in the CDW and 36,861 in the PCDC, with concordance rate of 98.7%. Mortality data from the NDI revealed 2,723 deaths with PCa as the underlying cause, of whom 75.4% had a recorded diagnosis of PCa in CDW. For all-cause mortality, 328,156 Veterans were identified as deceased in the CDW Vital Status File (VSF) and 326,707 were reported as deceased in the NDI, with a concordance rate of 99.3% deaths between the two sources. Comparing incident PCa diagnoses for all patients, we found that the CDW had a high sensitivity 98.6% and specificity 99.9%. Similarly, for cause specific death, the sensitivity rate was 75.5% and specificity was 100.0%.
Conclusions: The findings demonstrate a high level of concordance in key outcomes of interest, specifically, prostate cancer (PCa) diagnosis between the CDW and PCDC, and all-cause mortality between CDW VSF and NDI data sources. Given the time-consuming nature of data retrieval and management from the CDW, we recommend using the PCDC for PCa diagnosis and CDW VSF for all-cause mortality ascertainment.
利益披露 Disclosure
M. Gebregziabher, None..
K. G. Bishu, None..
A. Schreiner, None.