Recording type 2 diabetes mellitus in a standardised central Saudi database: a retrospective validation study

OBJECTIVES

This study was conducted to assess the validity of recording (and the original diagnostic practice) of type 2 diabetes mellitus at a hospital whose records were integrated to a centralised database (the standardised common data model (CDM) of the Saudi National Pharmacoepidemiologic Database (NPED)).

DESIGN

A retrospective single-centre validation study.

SETTINGS

Data of the study participants were extracted from the CDM of the NPED (only records of one tertiary care hospital were integrated at the time of the study) between 1 January 2013 and 1 July 2018.

PARTICIPANTS

A random sample of patients with type 2 diabetes mellitus (≥18 years old and with a code of type 2 diabetes mellitus) matched with a control group (patients without diabetes) based on age and sex.

OUTCOME MEASURES

The standardised coding of type 2 diabetes in the CDM was validated by comparing the presence of diabetes in the CDM versus the original electronic records at the hospital, the recording in paper-based medical records, and the physician re-assessment of diabetes in the included cases and controls, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were estimated for each pairwise comparison using RStudio V.1.4.1103.

RESULTS

A total of 437 random sample of patients with type 2 diabetes mellitus was identified and matched with 437 controls. Only 190 of 437 (43.0%) had paper-based medical records. All estimates were above 90% except for sensitivity and specificity of CDM versus paper-based records (54%; 95% CI 47% to 61% and 68%; 95% CI 62% to 73%, respectively).

CONCLUSIONS

This study provided an assessment to the extent of which only type 2 diabetes mellitus code can be used to identify patients with this disease at a Saudi centralised database. A future multi-centre study would help adding more emphasis to the study findings.

[Intraorbital tumors in children. Two cases and review of the literature]

Also in childhood, the orbital cavity is a possible place for different kinds of lesions. The recent contribution of magnetic risonance imaging (MRI) enables a more accurate differential diagnosis of intraorbital pathology. The clinical and neuroradiological data of two new patients affected respectively by intraorbital meningioma and schwannoma are presented. Both patients showed exophthalmos without pain and were treated with surgery. The different etiologies of intraorbital lesions, i.e. vascular, neoplastic, inflammatory, cystic and malformative are analyzed. Sometimes the case history and neuroradiological assessment alone enable a correct diagnosis. More often, however, only surgery reveals the exact nature of the disease. The age of the patient too can represent a criteria for a possible differential diagnosis.