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

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

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

ApplicationandValidationofCase-FindingAlgorithms forIdentifyingIndividualswithHuman ImmunodeficiencyVirusfromAdministrativeDatain BritishColumbia,Canada BohdanNosyk1,GuillaumeColley1,BenitaYip1,KeithChan1,KatherineHeath1,VivianeD.Lima1,2, MarkGilbert3,4,RobertS.Hogg1,5,P.RichardHarrigan1,2,JulioS.G.Montaner1,2*,onbehalfoftheSTOP HIV/AIDSStudyGroup 1BCCentreforExcellenceinHIV/AIDS,Vancouver,BritishColumbia,Canada,2DivisionofAIDS,FacultyofMedicine,UniversityofBritishColumbia,Vancouver,British Columbia,Canada,3ClinicalPreventionServices,BCCentreforDiseaseControl,Vancouver,BritishColumbia,Canada,4SchoolofPopulationandPublicHealth,University ofBritishColumbia,Vancouver,BritishColumbia,Canada,5FacultyofHealthSciences,SimonFraserUniversity,Vancouver,BritishColumbia,Canada Abstract Objective:Todefineapopulation-levelcohortofindividualsinfectedwiththehumanimmunodeficiencyvirus(HIV)inthe provinceofBritishColumbiafromavailableregistriesandadministrativedatasetsusingavalidatedcase-findingalgorithm. Methods:IndividualswereidentifiedforpossiblecohortinclusionfromtheBCCentreforExcellenceinHIV/AIDS(CfE)drug treatmentprogram(antiretroviraltherapy)andlaboratorytestingdatasets(plasmaviralload(pVL)andCD4diagnostictest results), the BC Centre for Disease Control (CDC) provincial HIV surveillance database (positive HIV tests), as well as databasesheldbytheBCMinistryofHealth(MoH);theDischargeAbstractDatabase(hospitalizations),theMedicalServices Plan(physicianbilling)andPharmaNetdatabases(additionalHIV-relatedmedications).Avalidatedcase-findingalgorithm wasappliedtodistinguishtrueHIVcasesfromthoselikelytohavebeenmisclassified.Thesensitivityofthealgorithmswas assessedastheproportionofconfirmedcases(thosewithrecordsintheCfE,CDCandMoHdatabases)positivelyidentified byeachalgorithm.Apriorihypothesesweregeneratedandtestedtoverifyexcludedcases. Results: A total of 25,673 individuals were identified as having at least one HIV-related health record. Among 9,454 unconfirmedcases,theselectedcase-find