Performance of administrative case definitions for comorbidity in multiple sclerosis in Manitoba and Nova Scotia

Ruth Ann Marrie, J. D. Fisk, K. J. Stadnyk, Helen Tremlett, Christina Wolfson, Sharon Warren, Virender Bhan, Bo Nancy Yu, Stella Leung, Lawrence Elliott, Patricia Caetano, James F. Blanchard, Lawrence W. Svenson, Joanne Profetto-McGrath, Nathalie Jette, Scott B. Patten, Charity Evans, Michelle Ploughman

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Introduction: As the population ages and the prevalence of comorbid conditions increases, the need for feasible, validated methods of comorbidity surveillance in chronic diseases such as multiple sclerosis (MS) increases. Methods: Using kappa (k) statistics, we evaluated the performance of administrative case definitions for comorbidities commonly observed in MS by comparing agreement between Manitoba (MB) administrative data and self-report (n = 606) and Nova Scotia (NS) administrative data and self-report (n = 1923). Results: Agreement between the administrative definitions and self-report was substantial for hypertension (k = 0.69 [NS], 0.76 [MB]) and diabetes (k = 0.70 [NS], 0.66 [MB]); moderate for hyperlipidemia (k = 0.53 [NS], 0.51 [MB]) and heart disease (k = 0.42 [NS], 0.51 [MB]) and fair for anxiety (k = 0.27 [NS], 0.26 [MB]). In NS, agreement was substantial for inflammatory bowel disease (k = 0.71) and moderate for epilepsy (k = 0.48). Conclusion: Administrative definitions for commonly observed comorbidities in MS performed well in 2 distinct jurisdictions. This suggests that they could be used more broadly across Canada and in national studies.

Original languageEnglish
Pages (from-to)145-153
Number of pages9
JournalChronic Diseases and Injuries in Canada
Issue number2-3
StatePublished - Jul 2014
Externally publishedYes


  • Administrative data
  • Comorbidity
  • Multiple sclerosis
  • Validation


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