丹麦国家患者登记处:内容、数据质量及研究潜力综述
The Danish National Patient Registry: a review of content, data quality, and research potential.
作者信息
Schmidt Morten, Schmidt Sigrun Alba Johannesdottir, Sandegaard Jakob Lynge, Ehrenstein Vera, Pedersen Lars, Sørensen Henrik Toft
机构信息
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Health Documentation, State Serum Institute, Copenhagen, Denmark.
出版信息
Clin Epidemiol. 2015 Nov 17;7:449-90. doi: 10.2147/CLEP.S91125. eCollection 2015.
BACKGROUND
The Danish National Patient Registry (DNPR) is one of the world's oldest nationwide hospital registries and is used extensively for research. Many studies have validated algorithms for identifying health events in the DNPR, but the reports are fragmented and no overview exists.
OBJECTIVES
To review the content, data quality, and research potential of the DNPR.
METHODS
We examined the setting, history, aims, content, and classification systems of the DNPR. We searched PubMed and the Danish Medical Journal to create a bibliography of validation studies. We included also studies that were referenced in retrieved papers or known to us beforehand. Methodological considerations related to DNPR data were reviewed.
RESULTS
During 1977-2012, the DNPR registered 8,085,603 persons, accounting for 7,268,857 inpatient, 5,953,405 outpatient, and 5,097,300 emergency department contacts. The DNPR provides nationwide longitudinal registration of detailed administrative and clinical data. It has recorded information on all patients discharged from Danish nonpsychiatric hospitals since 1977 and on psychiatric inpatients and emergency department and outpatient specialty clinic contacts since 1995. For each patient contact, one primary and optional secondary diagnoses are recorded according to the International Classification of Diseases. The DNPR provides a data source to identify diseases, examinations, certain in-hospital medical treatments, and surgical procedures. Long-term temporal trends in hospitalization and treatment rates can be studied. The positive predictive values of diseases and treatments vary widely (<15%-100%). The DNPR data are linkable at the patient level with data from other Danish administrative registries, clinical registries, randomized controlled trials, population surveys, and epidemiologic field studies - enabling researchers to reconstruct individual life and health trajectories for an entire population.
CONCLUSION
The DNPR is a valuable tool for epidemiological research. However, both its strengths and limitations must be considered when interpreting research results, and continuous validation of its clinical data is essential.
背景
丹麦国家患者登记处(DNPR)是世界上最古老的全国性医院登记处之一,被广泛用于研究。许多研究已经验证了在DNPR中识别健康事件的算法,但报告零散,缺乏综述。
目的
回顾DNPR的内容、数据质量和研究潜力。
方法
我们研究了DNPR的设置、历史、目标、内容和分类系统。我们检索了PubMed和《丹麦医学杂志》以创建验证研究的参考文献目录。我们还纳入了检索到的论文中引用的或我们事先已知的研究。回顾了与DNPR数据相关的方法学考量。
结果
在1977年至2012年期间,DNPR登记了8,085,603人,包括7,268,857例住院患者、5,953,405例门诊患者和5,097,300例急诊科就诊患者。DNPR提供全国范围内详细行政和临床数据的纵向登记。它记录了自1977年以来从丹麦非精神病医院出院的所有患者的信息,以及自1995年以来精神病住院患者、急诊科和门诊专科诊所就诊患者的信息。对于每次患者就诊,根据国际疾病分类记录一个主要诊断和一个可选的次要诊断。DNPR提供了一个数据源,可用于识别疾病、检查、某些住院医疗治疗和外科手术。可以研究住院率和治疗率的长期时间趋势。疾病和治疗的阳性预测值差异很大(<15%-100%)。DNPR数据在患者层面可与来自其他丹麦行政登记处、临床登记处、随机对照试验、人口调查和流行病学现场研究的数据相链接,使研究人员能够重构整个人口的个体生活和健康轨迹。
结论
DNPR是流行病学研究的宝贵工具。然而,在解释研究结果时必须同时考虑其优势和局限性,并且对其临床数据进行持续验证至关重要。