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验证大学健康联盟管理数据集:与患者层面机构数据的一致性和差异性。

Validation of the University HealthSystem Consortium administrative dataset: concordance and discordance with patient-level institutional data.

机构信息

Cincinnati Research on Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio.

Clinical Research Division, University HealthSystem Consortium, Chicago, Illinois.

出版信息

J Surg Res. 2014 Aug;190(2):484-90. doi: 10.1016/j.jss.2014.03.044. Epub 2014 Mar 21.

Abstract

BACKGROUND

The University HealthSystem Consortium Clinical Database-Resource Manager (UHC CD-RM) is an administrative database increasingly queried for both research and administrative purposes, but it has not been comprehensively validated. To address this knowledge gap, we compared the UHC CD-RM with an institutional dataset to determine its validity and accuracy.

MATERIALS AND METHODS

Age, gender, and date of operation were used to identify patients undergoing pancreaticoduodenectomy from 2009-2011 in both the UHC CD-RM and our institutional pancreatic surgery database. Patient- and intervention-specific variables including perioperative mortality, complications, length of stay, discharge disposition, and readmission were compared between datasets.

RESULTS

A total of 107 UHC CD-RM and 105 institutional patients met inclusion criteria. In both datasets 103 matched cases were present. Between the 103 matched cases, there was concordance with respect to median age (P = 0.87), gender (P = 0.89), race (P = 0.84), overall length of stay (P = 0.46), discharge disposition (P = 0.95), 30-d readmission rate (P = 0.87), and 30-d mortality (P = 0.70). Most comorbidities and complications were captured; however, several disease-specific complications were absent within the UHC CD-RM.

CONCLUSIONS

Most of the clinically significant patient- and intervention-specific variables within the UHC CD-RM are reliably reported. With recognition of its limitations, the UHC CD-RM is a reliable surrogate for institutional medical records and should be considered a valuable research tool for health service researchers.

摘要

背景

大学健康联盟临床数据库-资源管理器(UHC CD-RM)是一个行政数据库,越来越多地被用于研究和行政目的,但尚未得到全面验证。为了解决这一知识空白,我们将 UHC CD-RM 与机构数据集进行比较,以确定其有效性和准确性。

材料和方法

使用年龄、性别和手术日期从 2009 年至 2011 年在 UHC CD-RM 和我们机构的胰腺手术数据库中识别接受胰十二指肠切除术的患者。比较数据集之间的围手术期死亡率、并发症、住院时间、出院去向和再入院等患者和干预特定变量。

结果

共有 107 例 UHC CD-RM 和 105 例机构患者符合纳入标准。在两个数据集均有 103 例匹配病例。在 103 例匹配病例中,中位数年龄(P=0.87)、性别(P=0.89)、种族(P=0.84)、总住院时间(P=0.46)、出院去向(P=0.95)、30 天再入院率(P=0.87)和 30 天死亡率(P=0.70)具有一致性。大多数合并症和并发症都被捕获;然而,UHC CD-RM 中存在一些特定于疾病的并发症。

结论

UHC CD-RM 中大多数与临床意义相关的患者和干预特定变量都得到了可靠的报告。认识到其局限性,UHC CD-RM 是机构病历的可靠替代品,应被视为卫生服务研究人员的有价值的研究工具。

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