Yasmeen Shagufta, Romano Patrick S, Schembri Michael E, Keyzer Janet M, Gilbert William M
Department of Obstetrics and Gynecology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
Am J Obstet Gynecol. 2006 Apr;194(4):992-1001. doi: 10.1016/j.ajog.2005.08.058.
The objective of the study was to estimate the validity of obstetric procedures and diagnoses in California patient discharge data.
We randomly sampled 1611 deliveries from 52 of 267 California hospitals that performed more than 678 eligible deliveries in 1992 to 1993. We compared hospital-reported procedures and diagnoses against our recoding of the same records.
Cesarean, forceps, and vacuum delivery were accurately reported, with sensitivities and positive predictive values exceeding 90%. Episiotomy was underreported (70% sensitivity). Cesarean indications were reported with at least 60% sensitivity, except uterine inertia, herpes, and long labor. Among comorbidities, sensitivity exceeded 60% for chorioamnionitis, diabetes, premature labor, preeclampsia, and intrauterine death. Sensitivity was poor (less than 60%) for anemia, asthma, thyroid disorders, mental disorders, drug abuse, genitourinary infections, obesity, fibroids, excessive fetal growth, hypertension, premature rupture, polyhydramnios, and postdates.
The validity of hospital-reported obstetric procedures and diagnoses varies, with moderate to high accuracy for some codes but poor accuracy for others.
本研究的目的是评估加利福尼亚州患者出院数据中产科手术和诊断的有效性。
我们从1992年至1993年进行了超过678例符合条件分娩的267家加利福尼亚医院中的52家随机抽取了1611例分娩病例。我们将医院报告的手术和诊断与我们对相同记录的重新编码进行了比较。
剖宫产、产钳助产和真空吸引分娩报告准确，敏感性和阳性预测值超过90%。会阴切开术报告不足（敏感性70%）。剖宫产指征报告的敏感性至少为60%，但子宫收缩乏力、疱疹和产程延长除外。在合并症中，绒毛膜羊膜炎、糖尿病、早产、先兆子痫和宫内死亡的敏感性超过60%。贫血、哮喘、甲状腺疾病、精神疾病、药物滥用、泌尿生殖系统感染、肥胖、子宫肌瘤、胎儿过度生长、高血压、胎膜早破、羊水过多和过期妊娠的敏感性较差（低于60%）。
医院报告的产科手术和诊断的有效性各不相同，某些编码的准确性中等至高，但其他编码的准确性较差。
