Kidney Health Service, Metro North Hospitals and Health Service, Department of Nephrology, Royal Brisbane and Women's Hospital, Australia.
Faculty of Medicine, University of Queensland, Australia.
Health Inf Manag. 2023 Sep;52(3):212-220. doi: 10.1177/18333583221097724. Epub 2022 Jun 11.
Clinical quality registries provide rich and useful data for clinical quality monitoring and research purposes but are susceptible to data quality issues that can impact their usage. : This study assessed the concordance between comorbidities recorded in the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and those in state-based hospital admission datasets. All patients in New South Wales, South Australia, Tasmania, Victoria and Western Australia recorded in ANZDATA as requiring chronic kidney replacement therapy (KRT) between 01/07/2000 and 31/12/2015 were linked with state-based hospital admission datasets. Coronary artery disease, diabetes mellitus, cerebrovascular disease, chronic lung disease and peripheral vascular disease recorded in ANZDATA at each annual census date were compared overall, over time and between different KRT modalities to comorbidities recorded in hospital admission datasets, as defined by the International Classification of Diseases (ICD-10-AM), using both the kappa statistic and logistic regression analysis. 29, 334 patients with 207,369 hospital admissions were identified. Comparison was made at census date for every patient comparison. Overall agreement was "very good" for diabetes mellitus (92%, k = 0.84) and "poor" to "fair" (21-61%, k = 0.02-0.22) for others. Diabetes mellitus recording had the highest accuracy (sensitivity 93% (±SE 0.2) and specificity 93% (±SE 0.2)), and cerebrovascular disease had the lowest (sensitivity 54% (±SE 0.2) and specificity 21% (±SE 0.3)). The false positive rates for cerebrovascular disease, peripheral vascular disease and chronic airway disease ranged between 18 and 33%. The probability of a false positive was lowest for kidney transplant patients for all comorbidities and highest for patients on haemodialysis. Agreement between the clinical quality registry and hospital admission datasets was variable, with the prevalence of comorbidities being higher in ANZDATA.
临床质量登记处为临床质量监测和研究提供了丰富而有用的数据，但容易出现数据质量问题，从而影响其使用。本研究评估了澳大利亚和新西兰透析和移植（ANZDATA）登记处记录的合并症与州级住院数据集之间的一致性。在 2000 年 7 月 1 日至 2015 年 12 月 31 日期间，需要慢性肾脏替代治疗（KRT）的所有新南威尔士州、南澳大利亚州、塔斯马尼亚州、维多利亚州和西澳大利亚州的患者在 ANZDATA 中记录，并与州级住院数据集进行了链接。在每年的普查日期，在 ANZDATA 中记录的冠状动脉疾病、糖尿病、脑血管疾病、慢性肺部疾病和外周血管疾病与根据国际疾病分类（ICD-10-AM）在住院数据集记录的合并症进行了总体比较、随时间推移的比较以及不同 KRT 模式之间的比较，并使用kappa 统计和逻辑回归分析。共确定了 29334 名患者的 207369 次住院记录，每次患者比较都在普查日期进行。总体一致性为糖尿病（92%，k = 0.84）“非常好”，其他疾病（21-61%，k = 0.02-0.22）“差”至“一般”。糖尿病记录的准确性最高（灵敏度 93%（±SE 0.2）和特异性 93%（±SE 0.2）），而脑血管疾病的准确性最低（灵敏度 54%（±SE 0.2）和特异性 21%（±SE 0.3））。脑血管疾病、外周血管疾病和慢性气道疾病的假阳性率在 18%至 33%之间。对于所有合并症，肾移植患者的假阳性概率最低，血液透析患者的假阳性概率最高。临床质量登记处与住院数据集之间的一致性存在差异，ANZDATA 中的合并症患病率更高。
