Department of Clinical Sciences in Lund, Lund University, Lund, Sweden.
Department of Otorhinolaryngology, Division of Speech and Language Pathology, Skåne University Hospital, Malmö, Sweden.
Logoped Phoniatr Vocol. 2024 Apr;49(1):27-33. doi: 10.1080/14015439.2022.2095017. Epub 2022 Jul 4.
Data in national health care quality registries must be valid and reliable in order to enable open comparisons of results.
To assess the reliability of data on percent consonants correct (PCC) and its associated quality indicator ≥ in the Swedish quality registry for patients born with cleft lip and palate (CLP) registry.
Six independent speech-language pathologists re-assessed the audio recordings of 96 five-year-olds with PCC data in the CLP registry. Target consonants of a single-word picture-naming test were phonetically transcribed, and PCC was calculated. The reliability of PCC data was assessed with the intraclass correlation coefficient (ICC). The reliability of the quality indicator ≥ was assessed with point-by-point percentage agreement and Cohen's kappa.
Intra- and inter-judge agreement for PCC was excellent with ICCs above 0.9, and so was the agreement of data from the CLP registry and the six judges' re-assessments. The percentage agreement between all judges and the CLP registry for the quality indicator ≥ was poor (67%). However, in 88% of the cases, results from four judges and the CLP registry agreed, corresponding to good agreement. The mean of all kappa values for six judges and the CLP registry corresponded to good agreement (0.72).
The results indicate the PCC data in the CLP registry and the quality indicator ≥ to be reliable. When differences in outcome between treatment centres are detected, the raw data collected should always be re-examined before drawing definitive conclusions.
为了能够对结果进行公开比较,国家医疗保健质量注册处的数据必须是有效和可靠的。
评估瑞典唇腭裂患者质量注册处中有关百分率相符(PCC)及其相关质量指标≥的数据的可靠性。
6 名独立的言语语言病理学家对唇腭裂注册处中具有 PCC 数据的 96 名 5 岁儿童的录音进行了重新评估。对单字图片命名测试的目标辅音进行了语音转录,并计算了 PCC。使用组内相关系数(ICC)评估 PCC 数据的可靠性。使用点对点百分比一致性和 Cohen's kappa 评估质量指标≥的可靠性。
PCC 的内部和外部法官一致性极好,ICC 值均高于 0.9,而且唇腭裂注册处和六位法官的重新评估数据之间的一致性也很好。所有法官和唇腭裂注册处之间的质量指标≥的百分比一致性较差(67%)。然而,在 88%的情况下,四位法官和唇腭裂注册处的结果一致,这对应于良好的一致性。六位法官和唇腭裂注册处的所有 kappa 值的平均值对应于良好的一致性(0.72)。
结果表明唇腭裂注册处的 PCC 数据和质量指标≥是可靠的。当检测到治疗中心之间的结果存在差异时,在得出明确结论之前,应始终重新检查所收集的原始数据。