关键变量的高完整性和准确报告使丹麦肩关节置换登记处的数据成为有价值的信息来源。
High Completeness and Accurate Reporting of Key Variables Make Data from the Danish Shoulder Arthroplasty Registry a Valuable Source of Information.
作者信息
Rasmussen Jeppe Vejlgaard, El-Galaly Anders, Thillemann Theis Muncholm, Jensen Steen Lund
机构信息
Department of Orthopaedic Surgery, Herlev-Gentofte Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
出版信息
Clin Epidemiol. 2021 Feb 22;13:141-148. doi: 10.2147/CLEP.S291972. eCollection 2021.
PURPOSE
The Danish Shoulder Arthroplasty Registry (DSR) is a nationwide database providing data for research and health care monitoring. The aim of this study was to validate the DSR by (1) assessing registration completeness, (2) comparing key variables with information from medical records, (3) assessing the number and proportion of missing data for key variables.
MATERIALS AND METHODS
The completeness of registration in the DSR from 2006-2015 was assessed for primary arthroplasties by comparing the number of arthroplasties reported to the DSR with the number of arthroplasties recorded by the Danish National Patient Register which is an administrative database used by the Danish healthcare authorities to monitor all hospitalizations including shoulder arthroplasty surgery. Positive predictive values (PPV) were used to estimate the accuracy of the reporting in a randomly selected population. Information retrieved from medical records were used as gold standard. The number of missing values for each variable was evaluated to depict if these registrations were missing at random.
RESULTS
The completeness of reporting was 94.4. The PPV for the three major indications: osteoarthritis, fracture and rotator cuff arthropathy was 92%, 97%, and 94%, respectively. PPV was high for resurfacing arthroplasty (93%) and reverse shoulder arthroplasty (93%), but low for total shoulder arthroplasty (79%) and hemiarthroplasty (83%). The proportion of missing data in DSR was less than 1% for age, gender, previous surgery, indication and arthroplasty type and these can be regarded as missing at random.
CONCLUSION
The study showed that data from the DSR are sufficiently valid to be used for research and quality monitoring. Lower PPV's for total shoulder arthroplasty and hemiarthroplasty are possibly related to inadequate definitions and mutually nonexclusive items in the reporting form. Regular validation is necessary since the data reported to the registry continuously evolve because of changes in clinical practice.
目的
丹麦肩部置换登记处（DSR）是一个全国性数据库，可为研究和医疗保健监测提供数据。本研究的目的是通过以下方式验证DSR：（1）评估登记完整性；（2）将关键变量与病历信息进行比较；（3）评估关键变量缺失数据的数量和比例。
材料与方法
通过比较向DSR报告的关节置换手术数量与丹麦国家患者登记处记录的关节置换手术数量，评估2006 - 2015年DSR中初次关节置换手术的登记完整性。丹麦国家患者登记处是丹麦医疗当局用于监测包括肩部置换手术在内的所有住院情况的行政数据库。阳性预测值（PPV）用于估计随机选择人群中报告的准确性。从病历中检索的信息用作金标准。评估每个变量的缺失值数量，以描述这些登记是否随机缺失。
结果
报告的完整性为94.4。三种主要适应症（骨关节炎、骨折和肩袖关节病）的PPV分别为92%、97%和94%。表面置换关节成形术（93%）和反肩关节置换术（93%）的PPV较高，但全肩关节置换术（79%）和半关节置换术（83%）的PPV较低。DSR中年龄、性别、既往手术、适应症和关节置换类型的缺失数据比例小于1%，这些可视为随机缺失。
结论
该研究表明，DSR的数据足够有效，可用于研究和质量监测。全肩关节置换术和半关节置换术较低的PPV可能与报告表中定义不充分和相互不排斥的项目有关。由于临床实践的变化，向登记处报告的数据不断演变，因此需要定期进行验证。
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