急性脑卒中登记：丹麦脑卒中登记处和丹麦全国患者登记处的有效性。
Registration of acute stroke: validity in the Danish Stroke Registry and the Danish National Registry of Patients.
机构信息
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Neurology, Glostrup Hospital, Glostrup, Denmark.
出版信息
Clin Epidemiol. 2013 Dec 23;6:27-36. doi: 10.2147/CLEP.S50449. eCollection 2014.
BACKGROUND
The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]).
METHODS
Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke patients discharged from four major neurologic wards within a 7-day period in 2010, and estimated the sensitivity, specificity, positive predictive value, and negative predictive value of the DSR and the DNRP.
RESULTS
Using the first approach, we found a sensitivity of 97% (worst/best case scenario 92%-99%) in the DSR and 79% (worst/best case scenario 73%-84%) in the DNRP. The positive predictive value was 90% (worst/best case scenario 72%-98%) in the DSR and 79% (worst/best case scenario 62%-88%) in the DNRP. Using the second approach, we found a sensitivity of 91% (95% confidence interval [CI] 81%-96%) and 58% (95% CI 46%-69%) in the DSR and DNRP, respectively. The negative predictive value was 91% (95% CI 83%-96%) in the DSR and 72% (95% CI 62%-80%) in the DNRP. The specificity and positive predictive value did not differ among the registries.
CONCLUSION
Our data suggest a higher sensitivity in the DSR than the DNRP for acute stroke diagnoses, whereas the positive predictive value was comparable in the two data sources.
背景
对专门的卒中登记处的患者登记的有效性，鲜少进行研究，也很少与医院出院登记处进行比较。本研究的目的是检验专门的卒中登记处（丹麦卒中登记处[DSR]）和医院出院登记处（丹麦国家患者登记处[DNRP]）中患者登记的有效性。
方法
我们假设所有卒中患者都在 DSR、DNRP 或两者中进行了登记，首先确定了 2009 年登记的 75 名卒中患者样本，其中 25 名患者在 DSR 中登记，25 名患者在 DNRP 中登记，25 名患者在两个数据源中都进行了登记。我们使用病历作为金标准，随后评估了 DSR 和 DNRP 中卒中诊断的灵敏度和阳性预测值。其次，我们回顾了 2010 年 7 天内 4 个主要神经科病房出院的所有潜在卒中患者的 160 份病历，评估了 DSR 和 DNRP 的灵敏度、特异性、阳性预测值和阴性预测值。
结果
使用第一种方法，我们发现 DSR 的灵敏度为 97%（最差/最佳情况 92%-99%），DNRP 的灵敏度为 79%（最差/最佳情况 73%-84%）。DSR 的阳性预测值为 90%（最差/最佳情况 72%-98%），DNRP 的阳性预测值为 79%（最差/最佳情况 62%-88%）。使用第二种方法，我们发现 DSR 和 DNRP 的灵敏度分别为 91%（95%置信区间[CI]81%-96%）和 58%（95% CI 46%-69%）。DSR 的阴性预测值为 91%（95% CI 83%-96%），DNRP 的阴性预测值为 72%（95% CI 62%-80%）。登记处之间的特异性和阳性预测值无差异。
结论
我们的数据表明，DSR 对急性卒中诊断的灵敏度高于 DNRP，而两者的阳性预测值相当。
Zotero 插件