Ottesen Marianne
Gynaekologisk-obstetrisk Afdeling, Afsnit 537, Hvidovre Hospital, DK-2650 Hvidovre.
Ugeskr Laeger. 2009 Feb 2;171(6):404-8.
To validate the coding and local registration of vaginal prolapse surgery in 1996-1998, and reporting of such data to the Danish National Patient registry (LPR).
Comparison of different sets of data from the local data base (GS) and LPR, and retrospective study of 296 patient files.
The concordance between two GS-data sets was 96.4%, and 0-100% between different LPR-data sets. The validity of reporting of data from GS to LPR was 96.2% on the level of patient ID (cpr), and 99.3% concerning length of hospital stay. If a procedure was registered as a vaginal prolapse procedure the validity of this being true was 93.6%. 18 non-prolapse procedures were registered as vaginal procedures. The registration was incomplete in 12.5% due to typing or hearing errors or missing codes. The coding was misleading in 11.8%, due to lack of consensus on coding. 86.6% of errors were passed through from the patient file to GS and LPR. Through simple guidelines misleading use of combination of codes was reduced from 7% to 0.5%.
The validity of the two sets of GS data, and the reporting from GS to LPR of vaginal surgical procedures is satisfactory on the cpr-level. However, the validity of such register data is affected by the risk of errors when drawing such data, and by coding errors. The main problems are lack of consensus on which codes to use, and that codes for very different procedures are very much alike. To improve the quality and usefulness of register data in monitoring vaginal prolapse procedures consensus on coding is desirable. Different methods to increase the quality of coding are discussed.
验证1996 - 1998年阴道脱垂手术的编码及本地登记情况,并将此类数据报告给丹麦国家患者登记处(LPR)。
比较本地数据库(GS)和LPR中不同数据集,并对296份患者档案进行回顾性研究。
两个GS数据集之间的一致性为96.4%,不同LPR数据集之间的一致性为0 - 100%。从GS向LPR报告数据在患者身份证号码(cpr)层面的有效性为96.2%,在住院时长方面为99.3%。若一项手术被登记为阴道脱垂手术,其实际为该手术的有效性为93.6%。有18项非脱垂手术被登记为阴道手术。因打字或听力错误或编码缺失,登记不完整的情况占12.5%。由于编码缺乏共识,编码产生误导的情况占11.8%。86.6%的错误从患者档案传递到了GS和LPR。通过简单指南,编码组合的误导性使用从7%降至0.5%。
在cpr层面,两组GS数据以及从GS向LPR报告阴道手术程序的有效性令人满意。然而,此类登记数据的有效性受提取数据时的错误风险以及编码错误的影响。主要问题在于使用何种编码缺乏共识,以及截然不同的手术程序编码却极为相似。为提高登记数据在监测阴道脱垂手术中的质量和实用性,编码方面达成共识很有必要。讨论了提高编码质量的不同方法。