Madsen M, Balling H, Eriksen L S
Dansk Institut for Klinisk Epidemiologi, København.
Ugeskr Laeger. 1990 Jan 29;152(5):308-14.
Surveillance of development in the incidence of heart disease, particularly acute myocardial infarction (AMI) requires a valid system of registration of all cases of the disease. During the period 1972-1981, all admissions with the diagnosis AMI to hospitals in Greater Copenhagen and Arhus were registered in the Heart Register. From 1978, admissions to all Danish somatic hospitals were registered in the National Patient Register. In order to assess the validity of the two registers as regards registration of AMI, the two registers were compared for the years 1979 and 1980. This investigation includes computerized comparison of the registered admissions with AMI and also re-assessment of the diagnosis based on the summaries for a random sample of the admissions. Comparison of the two registers revealed considerable disagreements. Among the individuals who had been admitted with AMI according to the National Patient Register, only approximately 2/3 were registered with this diagnosis in the Heart Register, while almost all persons registered in the Heart Register could be found again in the National Patient Register with the same diagnosis. Technical problems in coding and electronic data analysis in the National Patient Register only appear to explain a lesser fraction of the disagreements as the diagnoses which were summed up in the upper part of the summaries showed reasonably good agreement with the diagnoses in the National Patient Register. Re-assessment of the diagnoses revealed that approximately 90% of the admissions with AMI could be verified, without modification, by reviewing the text of the summaries.(ABSTRACT TRUNCATED AT 250 WORDS)
监测心脏病发病率的发展情况，尤其是急性心肌梗死（AMI），需要一个有效的疾病病例登记系统。在1972年至1981年期间，所有诊断为AMI并入住大哥本哈根和奥胡斯医院的患者都被登记在心脏登记册中。从1978年起，所有丹麦躯体医院的入院情况都被登记在国家患者登记册中。为了评估这两个登记册在AMI登记方面的有效性，对1979年和1980年的两个登记册进行了比较。这项调查包括对登记的AMI入院病例进行计算机化比较，并根据随机抽取的入院病例摘要重新评估诊断。两个登记册的比较显示出相当大的差异。在根据国家患者登记册诊断为AMI的患者中，只有约2/3在心脏登记册中登记了该诊断，而在心脏登记册中登记的几乎所有人都能在国家患者登记册中再次找到相同诊断。国家患者登记册中的编码和电子数据分析技术问题似乎只能解释较小部分的差异，因为摘要上部总结的诊断与国家患者登记册中的诊断显示出相当好的一致性。对诊断的重新评估显示，通过审查摘要文本，约90%的AMI入院病例可以未经修改地得到核实。（摘要截选至250字）
