Sensitivity and specificity of algorithms for the identification of nonspecific low back pain in medico-administrative databases : PAIN

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Sensitivity and specificity of algorithms for the identification of nonspecific low back pain in medico-administrative databases

Ly, Antaroua,b,c,d; Sirois, Carolineb,c,e; Dionne, Clermont E.a,b,c,*

Author Information

aDepartment of Social and Preventive Medicine, Université Laval, Québec City, QC, Canada

bCentre de recherche du CHU de Québec-Université Laval, Québec City, QC, Canada

cCentre d'excellence sur le vieillissement de Québec (CEVQ) du Centre de recherche en santé durable VITAM, Québec City, QC, Canada

dCentre national de la recherche scientifique et technologique (CNRST)/Institut de recherche en sciences de la santé (IRSS), Ouagadougou, Burkina Faso

eFaculty of Pharmacy, Université Laval, Québec City, QC, Canada

*Corresponding author. Address: Department of Social and Preventive Medicine, Université Laval, Québec City, QC G1V 0A6, Canada. Tel.: +1 418 682 7511; fax: +1 418 682 7949. E-mail address: [email protected] (C. E. Dionne).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).

PAIN 164(7):p 1600-1607, July 2023. | DOI: 10.1097/j.pain.0000000000002861

Identifying nonspecific low back pain (LBP) in medico-administrative databases is a major challenge because of the number and heterogeneity of existing diagnostic codes and the absence of standard definitions to use as reference. The objective of this study was to evaluate the sensitivity and specificity of algorithms for the identification of nonspecific LBP from medico-administrative data using self-report information as the reference standard. Self-report data came from the PROspective Québec Study on Work and Health, a 24-year prospective cohort study of white-collar workers. All diagnostic codes that could be associated with nonspecific LBP were identified from the International Classification of Diseases, Ninth and Tenth Revisions (ICD-9 and ICD-10) in physician and hospital claims. Seven algorithms for identifying nonspecific LBP were built and compared with self-report information. Sensitivity analyses were also conducted using more stringent definitions of LBP. There were 5980 study participants with (n = 2847) and without (n = 3133) LBP included in the analyses. An algorithm that included at least 1 diagnostic code for nonspecific LBP was best to identify cases of LBP in medico-administrative data with sensitivity varying between 8.9% (95% confidence interval [CI] 7.9-10.0) for a 1-year window and 21.5% (95% CI 20.0-23.0) for a 3-year window. Specificity varied from 97.1% (95% CI 96.5-97.7) for a 1-year window to 90.4% (95% CI 89.4-91.5) for a 3-year window. The low sensitivity we found reveals that the identification of nonspecific cases of LBP in administrative data is limited, possibly due to the lack of traditional medical consultation.

© 2023 International Association for the Study of Pain

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