新南威尔士州关节置换临床结果登记处的数据质量审计
Data quality audit of the arthroplasty clinical outcomes registry NSW.
作者信息
Seagrave Kurt G, Naylor Justine, Armstrong Elizabeth, Leong Kwong-Ming, Descallar Joseph, Harris Ian A
机构信息
South Western Sydney Clinical School, Faculty of Medicine, UNSW Australia, Liverpool Hospital, Liverpool, NSW, 2170, Australia.
Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW, 2170, Australia.
出版信息
BMC Health Serv Res. 2014 Nov 20;14:512. doi: 10.1186/s12913-014-0512-6.
BACKGROUND
The Arthroplasty Clinical Outcomes Registry NSW (ACORN) was initiated in 2012. ACORN is a registry piloting within NSW, Australia with several participating hospitals; it aims to monitor patient-centred outcomes and post-surgical complications after total hip and knee arthroplasty. Using retrospective audit methodology, we aimed to investigate the completeness and accuracy of data in ACORN.
METHODS
We undertook a reabstracting audit of 100 clinical records of patients who underwent surgery in 2012/2013 (50 each from hospitals A and B). These records represented 27% (100/367) of patient entries in the ACORN registry, all of which were collected at either hospital A or hospital B. Firstly, data completeness was determined by identifying the proportion of missing data in the original data pro forma. Secondly, accuracy of the initial data extraction was determined by comparing these data to reabstracted data collated by an auditor blind to the outcomes of the initial extraction. Inaccuracies were ascertained to be a disagreement between categorical variables and for continuous data, a pre-determined window of error was established. Benchmarks for data completeness and accuracy were set at 95.0%; kappa and intraclass coefficient (ICC) calculations were also utilised to supplement this analysis. In addition, registry completeness (the percentage capture of eligible patients) was also determined as part of the data quality analysis.
RESULTS
Completeness and accuracy of submitted datasets were evaluated to be 99.0% (1259/1272) and 94.0% (2159/2296) respectively for Hospital A, and 99.3% (1589/1600) and 96.1% (2444/2542) for Hospital B. The majority of accuracy discrepancies pertained to medical history data. For Hospital A, 57.1% (28/49) of variables met the accuracy benchmark of 95%; 74.5% (38/51) of variables in Hospital B met this benchmark. Of the number of patients eligible for inclusion in the registry, 93.5% (660/706) were found to be included.
CONCLUSION
Levels of data completeness and accuracy were found to be high in the submitted datasets for both hospitals. However, important deficits were identified in the accuracy of patient comorbidities. More specific and clear data definitions, and a more thorough examination of medical records would be possible methods to improve the accuracy of deficient areas.
背景
新南威尔士州关节置换临床结果登记处（ACORN）于2012年启动。ACORN是澳大利亚新南威尔士州内的一个登记处试点，有几家参与医院；其旨在监测全髋关节和膝关节置换术后以患者为中心的结果及手术并发症。我们采用回顾性审计方法，旨在调查ACORN中数据的完整性和准确性。
方法
我们对2012/2013年接受手术的100例患者的临床记录进行了重新提取审计（医院A和医院B各50例）。这些记录占ACORN登记处患者录入数的27%（100/367），所有这些记录均在医院A或医院B收集。首先，通过确定原始数据表格中缺失数据的比例来确定数据完整性。其次，通过将这些数据与对初始提取结果不知情的审计员整理的重新提取数据进行比较，来确定初始数据提取的准确性。不准确之处确定为分类变量之间的不一致，对于连续数据，设定了一个预先确定的误差范围。数据完整性和准确性的基准设定为95.0%；还利用卡方和组内相关系数（ICC）计算来补充此分析。此外，登记处完整性（符合条件患者的纳入百分比）也作为数据质量分析的一部分进行了确定。
结果
医院A提交数据集的完整性和准确性分别评估为99.0%（1259/1272）和94.0%（2159/2296），医院B为99.3%（1589/1600）和96.1%（2444/2542）。大多数准确性差异与病史数据有关。对于医院A，57.1%（28/49）的变量达到了95%的准确性基准；医院B中74.5%（38/51）的变量达到了该基准。在符合纳入登记处条件的患者中，发现93.5%（660/706）被纳入。
结论
两家医院提交的数据集中数据完整性和准确性水平较高。然而，在患者合并症的准确性方面发现了重要缺陷。更具体明确的数据定义以及对病历进行更彻底的检查可能是提高缺陷领域准确性的方法。
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