University of Exeter Medical School, University of Exeter, Exeter, UK.
Behavioural Science and Health, University College London, London, UK.
BMJ Open. 2019 Jul 24;9(7):e029037. doi: 10.1136/bmjopen-2019-029037.
To assess the degree to which variations in publicly reported hospital scores arising from the English Cancer Patient Experience Survey (CPES) are subject to chance.
Secondary analysis of publically reported data.
English National Health Service hospitals.
72 756 patients who were recently treated for cancer in one of 146 hospitals and responded to the 2016 English CPES.
Spearman-Brown reliability of hospital scores on 51 evaluative questions regarding cancer care.
Hospitals varied in respondent sample size with a median hospital sample size of 419 responses (range 31-1972). There were some hospitals with generally highly reliable scores across most questions, whereas other hospitals had generally unreliable scores (the median reliability of question scores within individual hospitals varied between 0.11 and 0.86). Similarly, there were some questions with generally high reliability across most hospitals, whereas other questions had generally low reliability. Of the 7377 individual hospital scores publically reported (146 hospitals by 51 questions, minus 69 suppressed scores), only 34% reached a reliability of 0.7, the minimum generally considered to be useful. In order for 80% of the individual hospital scores to reach a reliability of 0.7, some hospitals would require a fourfold increase in number of respondents; although in a few other hospitals sample sizes could be reduced.
The English Patient Experience Survey represents a globally unique source for understanding experience of a patient with cancer; but in its present form, it is not reliable for high stakes comparisons of the performance of different hospitals. Revised sampling strategies and survey questions could help increase the reliability of hospital scores, and thus make the survey fit for use in performance comparisons.
评估英语癌症患者体验调查（CPES）中公开报告的医院评分差异在多大程度上是偶然的。
对公开报告的数据进行二次分析。
英国国民保健系统医院。
146 家医院中最近接受癌症治疗的 72756 名患者，他们对 2016 年的英语 CPES 做出了回应。
51 项关于癌症护理的评价问题的医院评分的斯皮尔曼-布朗可靠性。
医院的受访者样本量存在差异，中位数医院样本量为 419 个（范围为 31-1972）。有些医院的大多数问题评分普遍高度可靠，而其他医院的评分则普遍不可靠（单个医院内问题评分的中位数可靠性在 0.11 到 0.86 之间变化）。同样，有些问题在大多数医院的评分普遍较高，而其他问题的评分普遍较低。在公开报告的 7377 个医院评分中（146 家医院，51 个问题，减去 69 个被抑制的评分），只有 34%达到了 0.7 的可靠性，这是普遍认为有用的最低标准。为了使 80%的医院评分达到 0.7 的可靠性，一些医院需要将受访者的数量增加四倍；尽管在其他少数几家医院中，样本量可以减少。
英国患者体验调查代表了一个独特的全球资源，用于了解癌症患者的体验；但就目前形式而言，它不可靠，无法对不同医院的绩效进行高风险比较。修订的抽样策略和调查问题可以帮助提高医院评分的可靠性，从而使该调查适合用于绩效比较。
