INSERM, UMR S953, Epidemiological Research on Perinatal Health and Women's and Children's Health, F-75020, Paris, France.
J Clin Epidemiol. 2011 Sep;64(9):1014-22. doi: 10.1016/j.jclinepi.2010.11.015. Epub 2011 Feb 18.
To estimate the accuracy and reliability of the reporting of diagnoses and procedures related to severe acute maternal morbidity in French hospital discharge data.
The study, conducted in four French tertiary teaching hospitals, covered the years 2006 and 2007 and 30,607 deliveries. We identified severe maternal morbid events-eclampsia, pulmonary embolism, procedures related to postpartum hemorrhages, and intensive care-in administrative hospital discharge data and medical records and compared their recording. Information from medical records was the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value of the hospital discharge data for these events were calculated. False positives and false negatives were examined to identify the reasons for misrecorded information.
The PPV of the hospital discharge data was 20% for eclampsia. For procedures related to postpartum hemorrhages, the PPVs were high, but sensitivities were lower; however, 95% of recording errors could be corrected. All indicators for intensive care exceeded 98%.
Intensive care and procedures seem reliably reported in the hospital administrative database, which, therefore, can be used to monitor them. Using these data for monitoring diagnoses will require a greater investment by clinicians in the accuracy of their reporting.
评估法国医院出院数据中严重急性产妇发病率相关诊断和手术报告的准确性和可靠性。
本研究在法国四所三级教学医院进行，涵盖了 2006 年和 2007 年的 30607 例分娩。我们在行政医院出院数据和病历中确定了严重产妇发病率事件（子痫、肺栓塞、产后出血相关手术和重症监护），并对其记录进行了比较。病历信息是金标准。计算了这些事件的医院出院数据的灵敏度、特异性、阳性预测值（PPV）和阴性预测值。检查假阳性和假阴性以确定信息记录错误的原因。
医院出院数据中子痫的 PPV 为 20%。对于产后出血相关手术，PPV 较高，但灵敏度较低；但是，95%的记录错误可以得到纠正。所有关于重症监护的指标均超过 98%。
重症监护和手术似乎在医院行政数据库中得到了可靠的报告，因此可以用于监测。使用这些数据进行诊断监测将需要临床医生更加关注报告的准确性。
