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瑞典国家患者登记处桡骨远端骨折诊断的有效性。

Validity of distal radius fracture diagnoses in the Swedish National Patient Register.

机构信息

Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.

Department of Orthopaedic Surgery, Södersjukhuset, Stockholm, Sweden.

出版信息

Eur J Med Res. 2023 Sep 9;28(1):335. doi: 10.1186/s40001-023-01314-0.

Abstract

Distal radius fractures are one of the most common fractures in adults. More research is needed to establish evidence-based clinical practice guidelines to generate cost-effective and fair fracture treatment. The Swedish National Patient Register is a principal source for population-based epidemiologic studies in Sweden. The validity of some-but not all-diagnoses in the register is high. Little is known regarding the validity of registration of distal radius fractures.A dataset of cases registered with diagnosis of distal radius fracture (S52.5) or distal radius and ulna fracture (S52.6) were collected from the Swedish National Inpatient and Outpatient Registers. Six cohorts, each containing 240 simple random samples, were constructed. Radiographic reports and medical records were reviewed to confirm or reject the diagnosis as well as, in relevant cases, the surgical intervention. Positive predictive values (PPV) were calculated.The PPV for distal radius fracture in the register ranges between 92 and 100%, lower if coded as S52.6 and higher if there was an adherent code of surgical intervention. Codes for surgical intervention reached a PPV of 95-100%.In conclusion, the validity of the codes for diagnosis and the surgical treatment of distal radius fracture is high in the Swedish National Patient Register. According to our results, the register may be used as a reliable data source for population-based research of distal radius fractures.

摘要

桡骨远端骨折是成年人最常见的骨折之一。需要更多的研究来建立基于证据的临床实践指南,以实现具有成本效益和公平的骨折治疗。瑞典全国患者登记处是在瑞典进行基于人群的流行病学研究的主要来源。该登记处的一些但不是所有诊断的有效性都很高。关于桡骨远端骨折登记的有效性知之甚少。从瑞典全国住院和门诊登记处收集了一组以桡骨远端骨折(S52.5)或桡骨远端和尺骨骨折(S52.6)诊断登记的病例数据集。构建了六个队列,每个队列包含 240 个简单随机样本。审查放射报告和病历以确认或拒绝诊断,以及在相关情况下,审查手术干预情况。计算阳性预测值(PPV)。登记处中桡骨远端骨折的 PPV 介于 92%至 100%之间,如果编码为 S52.6,则较低,如果有手术干预的附加代码,则较高。手术干预的代码达到了 95-100%的 PPV。结论,瑞典全国患者登记处中桡骨远端骨折的诊断和手术治疗代码具有较高的有效性。根据我们的结果,该登记处可作为桡骨远端骨折的基于人群的研究的可靠数据源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fa2/10492293/6a24758421bb/40001_2023_1314_Fig1_HTML.jpg

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