Epidemiology: the study of a specific group of people
The University of Manitoba’s IBD Epidemiology Database
In 1995 we developed The University of Manitoba IBD Epidemiology Database. This database utilized the Manitoba Health Database and harnessed the fact that all Manitobans have a unique personal health identification number (PHIN) through which all of their health care contacts can be tracked. After mailing out surveys through nearly 400 doctors offices in Manitoba approximately half of Manitoba’s IBD patients responded and were willing to self report on their IBD allowing themselves to be documented in an IBD Research Registry
Through patients self report and after a chart review through doctors’ offices we were able to develop an administrative definition of IBD. This means that we could apply a certain rule (having at least 5 separate contacts with the health care system, either outpatient or hospital-based) to the Manitoba Health administrative database to identify all Manitobans with IBD with at least a 90% sensitivity and specificity. We could reapply this definition on a go-forward basis to anonymously document the incidence rates (number of new cases) and prevalence rates (number of all cases at any one time) of both Crohn’s disease and ulcerative colitis within Manitoba. We could determine the burden of disease by how many patients exist with these diseases. We could explore trends in incidence rates as well as patient demographics to potentially develop hypotheses as to disease causation.
Our job now is to pursue an understanding as to whether Manitoba is unique in Canada (or whether our high rates of IBD simply reflect the fact that the other provinces do not have similar data collection possibilities as we do), and what might cause the high rate of IBD.
In 2000, the incidence rate of Crohn’s disease was 17/100,000 and the prevalence rate was 260/100,000. There are approximately 3110 cases of Crohn’s disease in Manitoba.
In 2000, the incidence rate of ulcerative colitis was 15/100,000 and the prevalence rate was 234/100,000. There are approximately 2807 cases of ulcerative colitis in Manitoba.
Why do Manitobans have a such high rate of IBD? We are currently studying this question, for more information on the Risk Factor Study please click here.
Publications from the Manitoba IBD Epidemiology Database:
For a review on the changing patterns of IBD across the world and the possibility that infections might cause IBD see:
Shanahan F, Bernstein CN. The evolving epidemiology of inflammatory bowel disease. Current Opinion in Gastroenterology 2009; 25:301-5.
Bernstein CN, Shanahan F. Disorders of a modern lifestyle-reconciling the epidemiology of inflammatory bowel diseases. Gut 2008; 57: 1185-91.