英国囊性纤维化注册处目前对肺功能的报告是否允许对成人中心进行公平比较？
Does current reporting of lung function by the UK cystic fibrosis registry allow a fair comparison of adult centres?
机构信息
Department of Adult Cystic Fibrosis, University Hospital Southampton NHS Trust, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom.
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, United Kingdom.
出版信息
J Cyst Fibros. 2017 Sep;16(5):585-591. doi: 10.1016/j.jcf.2017.04.007. Epub 2017 Apr 24.
BACKGROUND
Outcome data for UK cystic fibrosis centres are publicly available in an annual report, which ranks centres by median FEV% predicted. We wished to assess whether there are differences in lung function outcomes between adult centres that might imply differing standards of care.
METHODS
UK Registry data from 4761 subjects at 34 anonymised adult centres were used to calculate mean FEV% and rate of change of lung function for 2007-13. These measures were used to rank centres and compare outcomes.
RESULTS
There are minor differences between centres for mean FEV% for some years of the study and for rate of change of lung function over the study period. However, rankings are critically dependent on the outcome measure chosen and centre variation becomes negligible once patient population characteristics are taken into account.
CONCLUSIONS
We have demonstrated that the ranking of centres is biased and any apparent difference in respiratory outcomes is unlikely to be related to differing standards of care between centres.
背景
英国囊性纤维化中心的结果数据在年度报告中公开，该报告按中位 FEV%预测值对中心进行排名。我们希望评估成人中心之间的肺功能结果是否存在差异，这可能意味着护理标准的不同。
方法
使用来自 34 个匿名成人中心的 4761 名受试者的英国登记处数据，计算 2007-13 年的平均 FEV%和肺功能变化率。这些措施用于对中心进行排名并比较结果。
结果
在研究的某些年份，中心之间的平均 FEV%存在微小差异，而在整个研究期间，肺功能变化率也存在差异。然而，排名严重依赖于所选的结果衡量标准，一旦考虑到患者人群特征，中心间的差异就变得微不足道了。
结论
我们已经证明，中心的排名存在偏差，任何呼吸结果的明显差异都不太可能与中心之间护理标准的不同有关。
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