Page Matthew, Wyeth Emma H, Samaranayaka Ari, McNoe Bronwen, Walker Rachael, Schollum John, Marshall Mark, Walker Robert, Derrett Sarah
Medical Student, Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin.
Senior Lecturer-Māori Health and Director, Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin.
N Z Med J. 2017 Apr 28;130(1454):65-71.
Sustained health inequities are experienced by indigenous and minority populations. Accurate ethnicity data are fundamental to healthcare planning and provision and monitoring of health outcomes to address such inequities. This study investigated the accuracy of ethnicity data in a large clinical registry of end-stage kidney disease patients (the Australia and New Zealand Dialysis and Transplant Registry; ANZDATA) and hospital-based patient clinical records compared with self-reported ethnicity data collected in the 'Dialysis Outcomes in those aged ≥65 years' (DOS65+) study.
Self-reported ethnicity data were collected, as per national guidelines, from DOS65+ participants and compared with ethnicity data recorded for these participants in ANZDATA and hospital-based patient clinical records. Ethnicities were first prioritised and then grouped into one of the following: European, Māori, Pacific, Asian and Other. Cohen's Kappa statistics were calculated to determine overall non-random agreement. Concordances for ethnic group categories were calculated.
There was high concordance between self-reported ethnicity and ethnicity recorded in both the ANZDATA (κ=0.95) and hospital-based patient clinical records (κ=0.93). Concordances for ethnic group categories between datasets ranged from 86% to 100%.
Our findings show a high level of agreement for ethnicity recorded for end-stage kidney disease patients between the three datasets, suggesting robust data to support health planning and research. Despite this, alignment of ethnicity data collection methods, as per national guidelines, should occur for all databases used for research and clinical practice in New Zealand.
原住民和少数族裔群体长期面临健康不平等问题。准确的种族数据对于医疗保健规划、服务提供以及健康结果监测以解决此类不平等现象至关重要。本研究调查了一个大型终末期肾病患者临床登记处(澳大利亚和新西兰透析与移植登记处;ANZDATA)以及医院患者临床记录中的种族数据与在“65岁及以上人群的透析结果”(DOS65+)研究中收集的自我报告种族数据相比的准确性。
按照国家指南,从DOS65+参与者中收集自我报告的种族数据,并与这些参与者在ANZDATA和医院患者临床记录中记录的种族数据进行比较。首先对种族进行优先级排序,然后将其分组为以下类别之一:欧洲裔、毛利人、太平洋岛民、亚洲人和其他。计算科恩kappa统计量以确定总体非随机一致性。计算种族类别之间的一致性。
自我报告的种族与ANZDATA(κ=0.95)和医院患者临床记录(κ=0.93)中记录的种族之间存在高度一致性。数据集之间种族类别的一致性范围为86%至100%。
我们的研究结果表明,三个数据集之间在终末期肾病患者记录的种族方面具有高度一致性,这表明有可靠的数据支持健康规划和研究。尽管如此,新西兰用于研究和临床实践的所有数据库都应按照国家指南统一种族数据收集方法。