Biobank and Registry Support Department, Division for medical quality registries for South- Eastern Norway Regional Health Authority, Oslo University Hospital, Oslo, Norway.
Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Scand J Trauma Resusc Emerg Med. 2023 Sep 26;31(1):50. doi: 10.1186/s13049-023-01118-5.
The Norwegian Trauma Registry (NTR) is designed to monitor and improve the quality and outcome of trauma care delivered by Norwegian trauma hospitals. Patient care is evaluated through specific quality indicators, which are constructed of variables reported to the registry by certified registrars. Having high-quality data recorded in the registry is essential for the validity, trust and use of data. This study aims to perform a data quality check of a subset of core data elements in the registry by assessing agreement between data in the NTR and corresponding data in electronic patient records (EPRs).
We validated 49 of the 118 variables registered in the NTR by comparing those with the corresponding ones in electronic patient records for 180 patients with a trauma diagnosis admitted in 2019 at eight public hospitals. Agreement was quantified by calculating observed agreement, Cohen's Kappa and Gwet's first agreement coefficient (AC) with 95% confidence intervals (CIs) for 27 nominal variables, quadratic weighted Cohen's Kappa and Gwet's second agreement coefficient (AC) for five ordinal variables. For nine continuous, one date and seven time variables, we calculated intraclass correlation coefficient (ICC).
Almost perfect agreement (AC /AC/ ICC > 0.80) was observed for all examined variables. Nominal and ordinal variables showed Gwet's agreement coefficients ranging from 0.85 (95% CI: 0.79-0.91) to 1.00 (95% CI: 1.00-1.00). For continuous and time variables there were detected high values of intraclass correlation coefficients (ICC) between 0.88 (95% CI: 0.83-0.91) and 1.00 (CI 95%: 1.00-1.00). While missing values in both the NTR and EPRs were in general negligeable, we found a substantial amount of missing registrations for a continuous "Base excess" in the NTR. For some of the time variables missing values both in the NTR and EPRs were high.
All tested variables in the Norwegian Trauma Registry displayed excellent agreement with the corresponding variables in electronic patient records. Variables in the registry that showed missing data need further examination.
挪威创伤登记处(NTR)旨在监测和改善挪威创伤医院提供的创伤护理的质量和结果。通过特定的质量指标来评估患者护理,这些指标是由认证登记员向登记处报告的变量构建的。在登记处记录高质量的数据对于数据的有效性、可信度和使用至关重要。本研究旨在通过评估 NTR 中的核心数据元素子集与电子患者记录(EPR)中对应数据之间的一致性,对登记处的数据质量进行检查。
我们通过比较 2019 年在八家公立医院就诊的 180 名创伤诊断患者的 NTR 中 118 个变量中的 49 个变量与电子患者记录中的对应变量,验证了 118 个变量中的 49 个变量。使用观察一致性、Cohen's Kappa 和 Gwet 的第一一致性系数(AC),对 27 个名义变量和五个有序变量的二次加权 Cohen's Kappa 和 Gwet 的第二一致性系数(AC)进行了量化。对于 9 个连续变量、1 个日期变量和 7 个时间变量,我们计算了组内相关系数(ICC)。
所有检查的变量都表现出几乎完美的一致性(AC / AC / ICC> 0.80)。名义和有序变量的 Gwet 一致性系数范围为 0.85(95%CI:0.79-0.91)至 1.00(95%CI:1.00-1.00)。对于连续和时间变量,组内相关系数(ICC)值较高,范围为 0.88(95%CI:0.83-0.91)至 1.00(95%CI:1.00-1.00)。虽然 NTR 和 EPR 中的缺失值通常可以忽略不计,但我们发现 NTR 中连续的“基础不足”有大量缺失记录。对于一些时间变量,NTR 和 EPR 中的缺失值都很高。
挪威创伤登记处的所有测试变量与电子患者记录中的相应变量都显示出极好的一致性。登记处中显示缺失数据的变量需要进一步检查。