使用纵向链接数据验证了既往剖宫产分娩的横断面报告。

Cross-sectional reporting of previous Cesarean birth was validated using longitudinal linked data.

机构信息

Clinical and Population Perinatal Health Research, The Kolling Institute of Medical Research, University of Sydney, New South Wales, Australia.

出版信息

J Clin Epidemiol. 2010 Jun;63(6):672-8. doi: 10.1016/j.jclinepi.2009.08.019. Epub 2009 Nov 17.

DOI:10.1016/j.jclinepi.2009.08.019

PMID:19926447

Abstract

OBJECTIVE

The aim of this study was to demonstrate the feasibility of using linked health records to assess data quality in population health data.

STUDY DESIGN AND SETTING

Reproductive histories of 155,897 women were constructed by longitudinal linkage of the New South Wales (Australia) birth records in 1998-2005, and 127,952 birth and hospital discharge records in 2000-2005 were cross-sectionally linked. History of Cesarean section (CS) derived from the longitudinal linkage ("gold standard") was used to validate the CS history fields (i.e., "Was the last birth by Cesarean section?" and "Total number of previous Cesarean sections?") in birth records and to validate "vaginal birth after previous Cesarean (VBAC)" and "maternal care for uterine scar" in hospital records.

RESULTS

The reporting of CS at last birth was reliable with sensitivity, specificity, positive predictive value (PPV), and negative predictive value all >95% as was the number of previous CS (weighted kappa=0.97). For the hospital data, sensitivity and PPV were 46% and 99% for VBAC, 92% and 99% for maternal care of uterine scar, and 85% and 99%, respectively, for any prior CS.

CONCLUSION

Assessing data quality by record linkage is feasible and can be done more quickly and cheaply than by any traditional validation study.

摘要

目的

本研究旨在展示利用健康记录链接来评估人群健康数据的数据质量的可行性。

研究设计和设置

通过对 1998-2005 年新南威尔士州（澳大利亚）出生记录进行纵向链接，构建了 155897 名女性的生育史，对 2000-2005 年的 127952 份出生和住院记录进行了横向链接。从纵向链接中得出的剖宫产史（CS）（“金标准”）用于验证出生记录中的 CS 史字段（即“上次分娩是否为剖宫产？”和“之前的剖宫产次数？”），并验证住院记录中的“前次剖宫产后的阴道分娩（VBAC）”和“子宫瘢痕的产妇护理”。

结果

最后一次分娩时 CS 的报告具有较高的可靠性，其敏感性、特异性、阳性预测值（PPV）和阴性预测值均>95%，而之前的 CS 次数也具有较高的可靠性（加权 Kappa=0.97）。对于医院数据，VBAC 的敏感性和 PPV 分别为 46%和 99%，子宫瘢痕产妇护理的敏感性和 PPV 分别为 92%和 99%，任何先前的 CS 的敏感性和 PPV 分别为 85%和 99%。