Ekström Magnus, Albrecht Dirk, Andersson Susanne, Grote Ludger, Kärrsten Rundström Birgitta, Palm Andreas, Theorell-Haglöw Jenny, Wahlberg Josefin, Midgren Bengt
Lund University, Faculty of Medicine, Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden.
Dept of Respiratory Medicine, Sunderby Hospital, Luleå, Sweden.
ERJ Open Res. 2021 Jan 18;7(1). doi: 10.1183/23120541.00340-2020. eCollection 2021 Jan.
The Swedish Registry of Respiratory Failure (Swedevox) collects nationwide data on patients starting continuous positive airway pressure (CPAP) treatment, long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT). We validated key information in Swedevox against source data from medical records.
This was a retrospective validation study of patients starting CPAP (n=175), LTMV (n=177) or LTOT (n=175) across seven centres 2013-2017. Agreement with medical record data was analysed using differences in means (sd) and proportion (%) of a selection of clinically relevant variables. Variables of interest included for CPAP: apnoea-hypopnoea index (AHI), height, weight, body mass index (BMI) and Epworth Sleepiness Scale (ESS) score; for LTMV: date of blood gas, arterial carbon dioxide tension ( ) (breathing air), weight and diagnosis group; and for LTOT: blood gases breathing air and oxygen, spirometry and main diagnosis.
Data on CPAP and LTOT had very high validity across all evaluated variables (all <5% discrepancy). For LTMV, variability was higher against source information for (>0.5 kPa in 25.9%), weight (>5 kg in 47.5%) and diagnosis group. Inconsistency was higher for patients starting LTMV acutely electively ( difference >0.5 kPa in 36% 21%, p<0.05, respectively). However, there were no signs of systematic bias (mean differences close to zero) across the evaluated variables.
Validity of Swedevox data, compared with medical records, was very high for CPAP, LTMV and LTOT. The large sample size and lack of systematic differences support that Swedevox data are valid for healthcare quality assessment and research.
瑞典呼吸衰竭登记处（Swedevox）收集全国范围内开始持续气道正压通气（CPAP）治疗、长期机械通气（LTMV）和长期氧疗（LTOT）患者的数据。我们对照病历源数据验证了Swedevox中的关键信息。
这是一项对2013 - 2017年七个中心开始CPAP（n = 175）、LTMV（n = 177）或LTOT（n = 175）治疗的患者进行的回顾性验证研究。使用选定临床相关变量的均值差异（标准差）和比例（%）分析与病历数据的一致性。CPAP关注的变量包括：呼吸暂停低通气指数（AHI）、身高、体重、体重指数（BMI）和爱泼华嗜睡量表（ESS）评分；LTMV关注的变量包括：血气日期、动脉血二氧化碳分压（ ）（呼吸空气时）、体重和诊断组；LTOT关注的变量包括：呼吸空气和吸氧时的血气、肺功能测定和主要诊断。
CPAP和LTOT的数据在所有评估变量中都具有很高的效度（所有差异均<5%）。对于LTMV，与源信息相比， （25.9%差异>0.5 kPa）、体重（47.5%差异>5 kg）和诊断组的变异性更高。急性开始LTMV的患者与择期开始LTMV的患者相比，不一致性更高（差异>0.5 kPa分别为36%和21%，p<0.05）。然而，在评估变量中没有系统偏差的迹象（均值差异接近零）。
与病历相比，Swedevox数据对于CPAP、LTMV和LTOT具有很高的效度。大样本量和缺乏系统差异支持Swedevox数据对于医疗质量评估和研究是有效的。
