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

Chapter 7
The research was conducted on mandatory regional registries set up following
regional and national law; therefore, according to national legislation, no informed
consent is required to obtain and store the information for public health and research
purposes. The authors of the paper were authorised by the regional public health
authorities to keep and analyse the data and to produce reports.
Sources of cases and record-linkage
Three sources were used to identify tuberculosis cases between 2000 and the first half of
2002. The first was the ‘physician notification system’, including both notification and
treatment outcome monitoring registers. The second source was the laboratory
tuberculosis register, which collects reports of microscopic and culture identification of
mycobacteria from the regional reference microbiology laboratories. The local public
health service periodically checks these records for false-positive reports due to
environmental mycobacteria and laboratory cross-contamination. Data from the
‘physician notification system’ and laboratory sources are not routinely merged and,
according to national legislation, only the notification register contributes to the official
national tuberculosis statistics. The third source of cases was the hospital discharge
records register. Hospital discharge records including any form of tuberculosis
(International Classification of Diseases-9 codes 0.10-0.18 and 647.3) were selected.
After correction for duplicate entries in each of the three registers, the records
of tuberculosis cases were matched by a deterministic linkage procedure using the
identifiers full name, date of birth and sex. Apparent matches were reviewed to avoid
homonymous and synonymous errors. Prevalent cases diagnosed in 2000 were identified
and were excluded from the study, whereas cases incident in 2001 were corrected for late
reporting in the first half of 2002. A case-verification procedure was performed by
inspecting the hospital charts of patients identified uniquely in this source to improve the
positive predictive value of this register. A similar procedure was not performed for cases
identified in the other sources, as case-verification is regularly performed by the public
health care services. We defined observed source-specific sensitivities as the number of
tuberculosis patients in each register divided by the total number of tuberculosis patients
observed after record-linkage. As local tuberculosis surveillance and control guidelines
advise to investigate the human immunodeficiency virus (HIV) status of adults with
tuberculosis after obtaining consent, information on HIV status was also collected.
Capture-recapture analysis
To use log-linear models for capture-recapture analysis, data from at least three different,
partially overlapping and preferably independent sources are necessary. 8,19 The annual
incidence and the estimated source-specific sensitivity (i.e. the number of observed
tuberculosis patients in each of the investigated sources divided by the estimated total
number of tuberculosis patients by capture-recapture analysis) of the regional tuberculosis
surveillance system were estimated by a three-sample capture-recapture analysis. 19 Pairwise
dependency between sources was incorporated into the log-linear models and
possible capture heterogeneity was tested. Capture-recapture analysis was conducted on
the full set of data and repeated for subsets defined according to geographical origin,
location of tuberculosis, age group, bacteriological status and site of residence, as
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