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基于人群的医院出院登记中血液系统恶性肿瘤ICD-10诊断的数据质量

The data quality of haematological malignancy ICD-10 diagnoses in a population-based hospital discharge registry.

作者信息

Nørgaard M, Skriver M V, Gregersen H, Pedersen G, Schønheyder H C, Sørensen H T

机构信息

Department of Clinical Epidemiology, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.

出版信息

Eur J Cancer Prev. 2005 Jun;14(3):201-6. doi: 10.1097/00008469-200506000-00002.

DOI:10.1097/00008469-200506000-00002
PMID:15901987
Abstract

The objectives of this study were to estimate the data quality of haematological malignancy diagnoses in a hospital discharge registry, and to quantify the impact of any misclassification of diagnoses on survival estimates. We included all patients > or = 15 years living in North Jutland County, Denmark with a first-time discharge diagnosis of a haematological malignancy registered in the Hospital Discharge Registry and the Danish Cancer Registry, the reference standard, from 1994 to 1999. We estimated completeness and positive predictive value (PPV) of haematological malignancies and specific subcategories, as a measure of data quality, and compared mortality rates based on data from the two registries by Cox regression analysis. Completeness in the Hospital Discharge Registry for all haematological malignancies was 91.5% (95% confidence interval (CI) 89.6-93.1) and PPV was 84.5% (95% CI 82.2-86.5). Reviews of the pathological files showed misclassified cases in both registries and thus indicated that both completeness and PPV of the Hospital Discharge Registry were underestimates. Mortality rate ratio for all haematological malignancies when registered in the Hospital Discharge Registry compared with being registered in the Danish Cancer Registry was 0.98 (95% CI 0.88-1.09). Discharge data had some misclassifications but these had no major impact on survival estimates.

摘要

本研究的目的是评估医院出院登记处血液系统恶性肿瘤诊断的数据质量,并量化诊断错误分类对生存估计的影响。我们纳入了丹麦北日德兰郡所有年龄≥15岁的患者,这些患者在1994年至1999年间首次因血液系统恶性肿瘤出院诊断而被登记在医院出院登记处和作为参考标准的丹麦癌症登记处。我们估计了血液系统恶性肿瘤及其特定亚类的完整性和阳性预测值(PPV),作为数据质量的衡量指标,并通过Cox回归分析比较了基于两个登记处数据的死亡率。医院出院登记处所有血液系统恶性肿瘤的完整性为91.5%(95%置信区间(CI)89.6 - 93.1),PPV为84.5%(95%CI 82.2 - 86.5)。对病理档案的审查显示两个登记处均存在分类错误的病例,因此表明医院出院登记处的完整性和PPV均被低估。与登记在丹麦癌症登记处相比,在医院出院登记处登记的所有血液系统恶性肿瘤的死亡率比值为0.98(95%CI 0.88 - 1.09)。出院数据存在一些分类错误,但这些对生存估计没有重大影响。

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