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In addition, we lacked 2-h glucose tolerance testing, which may have resulted in misclassification of prevalent and incident diabetes in our cohort.
To minimize the misclassification of prevalent cases, the analysis was restricted to at least a 5-year washout period without a code for IBD before the index date.
Subjects who had received a diagnosis of bladder cancer before cohort entry were excluded to avoid misclassification of prevalent cancers as incident cancers.
From this cohort of 207,389, we excluded 823 patients with a diagnosis of bladder cancer prior to entry in the cohort or within 6 months of joining KPNC to avoid misclassification of prevalent bladder cancers as incident diagnoses.
We also performed sensitivity analyses to minimize misclassification of prevalent cases by increasing the washout period from 3 to 5 years and excluding patients prescribed an immunosuppressant within 3 months of the index date.
Despite measures to evaluate misclassification of prevalent RA as incident RA cases (see Additional file 2), we cannot exclude misclassification of RA with other diseases with a longer prediagnostic period than that typically seen in RA, such as osteoarthritis.
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Fourth, defining incidence by "the first occurrence of the disease in the registry" leads to overestimation of incidence in the period immediately following the initiation of the DNPR, after initiation of a screening program, or after introduction of new registry codes, due to misclassification of "backlogged" prevalent cases as incident cases.
Another possible source of misclassification may be that not all cases of prevalent rheumatoid arthritis were excluded from the study cohort.
In accordance with literature, the common reasons for false positives were prevalent cancers or misclassification of cancer type [ 4].
Results from these sensitivity analyses were similar to the primary analysis, indicating minimal misclassification of unexposed patients as exposed and prevalent users as new users.
15 Although it is important to recognise that filling a prescription does not necessarily imply that the drugs are taken, we have no reason to believe that misclassification of drug use should be more prevalent in one sex.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com