Distributed Network Meta-Analysis Estimates Results from Individual-Level Analysis Using Ontario Health Administrative Data on Pediatric Inflammatory Bowel Disease Health Services Use: A Population-Based Cohort Study

Abstract

Over the last couple of decades changes to pediatric inflammatory bowel disease (IBD) care may have altered health services use among these children. I used a retrospective matched cohort design and population-based health administrative data to first quantify trends in IBD health services and surgical outcomes in Ontario IBD children diagnosed between 1994-2012. I then used these results to validate the distributed network analysis method – a method being increasingly used in Canadian multi-province studies where privacy regulations prevent sharing of individual-level data across provincial borders - using Ontario’s Local Health Integration Networks. I found (1) decreasing hospitalizations and surgical outcomes but increasing outpatient visit rates, suggesting changing patterns of health care use in Ontario children with IBD, and, (2) distributed network analyses is a satisfactory privacy-preserving alternative to individual-level analysis under the conditions tested in my study, providing a tested analysis method for researchers using multi-jurisdictional data.