Rob van Hest Capture-recapture Methods in Surveillance - RePub ...

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Underreporting of tuberculosis in the Netherlands Figure 6.3 Schematic view of the distribution of observed number of tuberculosis patients in the Netherlands in 1998, after record-linkage of three tuberculosis registers, and correction for possible misclassification of culture-positive patients and remaining falsepositive unlinked hospital cases (total number of observed cases is 1441). Notification (n = 1336) 301 548 388 Laboratory (n = 1006) Hospital (n = 552) notification of 8%. After correction for possibly misclassified laboratory patients and remaining false-positive hospital cases the adjusted observed under-notification of 7.3% is similar to this previous estimate. The 36.8% under-notification estimated by a log-linear capture-recapture model before adjustments were made is highly inconsistent with the prior report. Adjustment for possible misclassification of laboratory patients and remaining false-positive hospital cases had a considerable impact on the log-linear capture-recapture estimate. Possible causes of poor data quality The quality of the tuberculosis registers is mainly determined by the proportion of administrative discrepancies causing possible record-linkage misclassification (8.6% between Notification and Laboratory) and the proportion of false-positive cases (8.2% among non-culture-confirmed cases in this study after previous elimination of laboratory contamination records and exclusion of M. bovis BCG isolates). The majority of 40 99 30 35 89
Chapter 6 administrative discrepancies were found in the postal code. Apart from clerical errors, this could be due for example to frequent transfers of asylum seekers, notification of home address of prisoners versus laboratory postcode of prison region or assigning a random local postal code to records with missing data in some registers. Patients with a culture of M. bovis BCG were excluded because of an expected low positive predictive value for systemic disease as all were either infants (with likely a post-BCG vaccination abscess) or older males (with probable urological M. bovis BCG instillation). Despite maximum efforts to eliminate administrative discrepancies and falsepositive records, our results still indicate imperfect record-linkage as, assuming a negligible number of lost reports, only 91.1% of all tuberculosis cases in the Notification register could be linked to the NTR. Since tuberculosis physicians report to both registers the expected overlap is 100%. A proportion of the tuberculosis cases in the final dataset not present in the Notification register could be explained by imperfect record-linkage because, remarkably, 38 culture-confirmed but not notified patients were voluntarily reported to the NTR, suggesting notification as well. After adjustment the number of patients in the Notification register (1336) is almost similar as the number reported by the NTR in 1998 (1341). Still 70 culture-confirmed patients may not have been notified, reflecting the most serious public health aspect of under-notification, i.e. preventing possibly indicated contact investigations around potentially infectious patients. In almost one-quarter of the non-culture-confirmed patients histopathology examination contributed to the diagnosis tuberculosis. The majority of these patients were found in the Hospital register which is plausible because histopathology examination is more likely to be performed as part of a diagnostic work-up in patients with extrapulmonary tuberculosis requiring hospital admission. In the Netherlands, the contribution of PALGA to case-verification in addition to the NTR was limited. Despite the availability of additional tuberculosis-related registers, the majority (62.4%) of unlinked hospital cases could not be verified, compared to 7.6% of the unlinked notified cases. Although often used as a third data source in capture-recapture studies on human disease incidence, in the case of tuberculosis the data quality of hospital registers should be judged critically. A local capture-recapture study in the United Kingdom found 27% of all tuberculosis cases in the hospital register to be false-positive and in a regional capture-recapture study in Italy this was even 80% among unlinked hospital tuberculosis cases. 12,15 Limitations The findings have to be placed in the context of the limitations of this study. The estimated coverage of the tuberculosis registers was based on three-source log-linear capture-recapture models. These models are only valid in the absence of violation of their underlying assumptions: perfect record-linkage (i.e. no misclassification of records), a closed population (i.e. no immigration or emigration in the time period studied) and a homogeneous population (i.e. no subgroups with markedly different probabilities to be observed and re-observed). In two-source capture-recapture methods one must also assume independence between registers (i.e. the probability of being observed in one register is not affected by being (or not being) observed in another). In the three-source 90
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Capture-recapture Methods in Survei
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Colofon Capture-recapture methods i
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Promotiecommissie Promotor: Prof.dr
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Contents Page 1 Introduction 9 2 Me
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Chapter 1 1.1 Assessing completenes
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Chapter 1 94% among AIDS patients w
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Table 1.1 Objectives, methods, data
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Researchers Objective Method Data-s
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Chapter 1 source capture-recapture
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Chapter 1 32. Bradley BL, Kerr KM,
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2 Methodology of capture-recapture
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Methodology of capture-recapture an
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Page 39 and 40: Chapter 3 3.1 Application of captur
Page 41 and 42: Table 3.1 Published capture-recaptu
Page 43 and 44: Disease Authors Objective Method Da
Page 49 and 50: Chapter 3 3.3 References 1. Hook EB
Page 51 and 52: Chapter 3 52. Reintjes R, Termorshu
Page 53 and 54: Chapter 4 Abstract The aim of this
Page 55 and 56: Chapter 4 Methods Nearly all Dutch
Page 57 and 58: Chapter 4 Table 4.2 The number of m
Page 59 and 60: Chapter 4 diagnosis. Other patients
Page 61 and 62: Chapter 4 stratify the population i
Page 63 and 64: Chapter 4 25. Lambeth, Southwark an
Page 65 and 66: Chapter 5 Abstract To estimate inci
Page 67 and 68: Chapter 5 patients. Capture-recaptu
Page 69 and 70: Chapter 5 Figure 5.1 Four regions o
Page 71 and 72: Chapter 5 Hospital records From 385
Page 73 and 74: Chapter 5 Table 5.1 Epidemiological
Page 75 and 76: Table 5.2 Number and proportion of
Page 77 and 78: Chapter 5 cautious about the associ
Page 79 and 80: Chapter 5 Incidence of community-ac
Page 81 and 82: Chapter 6 Abstract The aim of this
Page 83 and 84: Chapter 6 3. Hospitalised patients
Page 85 and 86: Chapter 6 Record-linkage of all 537
Page 87 and 88: Chapter 6 Figure 6.1 Schematic view
Page 89: Chapter 6 Table 6.2 Total and strat
Page 93 and 94: Chapter 6 the patients, and complet
Page 96 and 97: 7 Undetected burden of tuberculosis
Page 98 and 99: Introduction Underreporting of tube
Page 100 and 101: Underreporting of tuberculosis in t
Page 102 and 103: Table 7.1 Total and subset numbers
Page 104 and 105: Table 7.2 Capture-recapture estimat
Page 106 and 107: Underreporting of tuberculosis in t
Page 108: Underreporting of tuberculosis in t
Page 111 and 112: Chapter 8 Abstract In 1999 the Enha
Page 113 and 114: Chapter 8 bacteriological confirmat
Page 115 and 116: Chapter 8 Results Table 8.1 shows t
Page 117 and 118: Table 8.3 Annual and overall observ
Page 119 and 120: Table 8.4 Annual and overall estima
Page 121 and 122: Chapter 8 interaction however, i.e.
Page 123 and 124: Chapter 8 shows that observed under
Page 126 and 127: 9 Estimating the coverage of tuberc
Page 128 and 129: Introduction Estimating targeted mo
Page 130 and 131: Estimating targeted mobile tubercul
Page 136 and 137: References Estimating targeted mobi
Page 138 and 139: 10 Estimating infectious diseases i
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Introduction Estimating infectious
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Estimating infectious disease incid
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Study Disease and number of patient
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4. Gallay A, Vaillant V, Bouvet P,
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Table 10.3 Comparison of the variou
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Discussion Estimating infectious di
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Chapter 11 The aim of this thesis i
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Chapter 11 overestimation of the nu
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Chapter 11 clinicians to the Public
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Chapter 11 operation with the chest
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Chapter 11 of the proportion of fal
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Chapter 11 Question 3: What is the
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Chapter 11 11.2 Some findings of th
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Chapter 11 • To improve timelines
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Summary Summary Surveillance is an
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Summary linkage of notification and
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Samenvatting Samenvatting Surveilla
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Samenvatting subgroepen binnen de b
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Acknowledgements Acknowledgements W
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Curriculum vitae Rob van Hest was b
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Publications This thesis Van Hest N
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