Data quality audit of the arthroplasty clinical outcomes registry NSW

BMC Health Services Research

Ian A Harris³  Joseph Descallar²  Kwong-Ming Leong¹  Elizabeth Armstrong⁴  Justine Naylor³  Kurt G Seagrave¹ 

[1]South Western Sydney Clinical School, Faculty of Medicine, UNSW Australia, Liverpool Hospital, Liverpool 2170, NSW, Australia

[2]Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool 2170, NSW, Australia

[3]South Western Sydney Local Health District, Elizabeth St, Liverpool, NSW, Australia

[4]Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool 2170, NSW, Australia

关键词: Registries;    Arthroplasty;    Medical records;    Medical audit;   

Others  :  1091330
DOI  :  10.1186/s12913-014-0512-6

 received in 2014-06-22, accepted in 2014-10-10,  发布年份 2014

【 摘 要 】

Background

The Arthroplasty Clinical Outcomes Registry NSW (ACORN) was initiated in 2012. ACORN is a registry piloting within NSW, Australia with several participating hospitals; it aims to monitor patient-centred outcomes and post-surgical complications after total hip and knee arthroplasty. Using retrospective audit methodology, we aimed to investigate the completeness and accuracy of data in ACORN.

Methods

We undertook a reabstracting audit of 100 clinical records of patients who underwent surgery in 2012/2013 (50 each from hospitals A and B). These records represented 27% (100/367) of patient entries in the ACORN registry, all of which were collected at either hospital A or hospital B. Firstly, data completeness was determined by identifying the proportion of missing data in the original data pro forma. Secondly, accuracy of the initial data extraction was determined by comparing these data to reabstracted data collated by an auditor blind to the outcomes of the initial extraction. Inaccuracies were ascertained to be a disagreement between categorical variables and for continuous data, a pre-determined window of error was established. Benchmarks for data completeness and accuracy were set at 95.0%; kappa and intraclass coefficient (ICC) calculations were also utilised to supplement this analysis. In addition, registry completeness (the percentage capture of eligible patients) was also determined as part of the data quality analysis.

Results

Completeness and accuracy of submitted datasets were evaluated to be 99.0% (1259/1272) and 94.0% (2159/2296) respectively for Hospital A, and 99.3% (1589/1600) and 96.1% (2444/2542) for Hospital B. The majority of accuracy discrepancies pertained to medical history data. For Hospital A, 57.1% (28/49) of variables met the accuracy benchmark of 95%; 74.5% (38/51) of variables in Hospital B met this benchmark. Of the number of patients eligible for inclusion in the registry, 93.5% (660/706) were found to be included.

Conclusion

Levels of data completeness and accuracy were found to be high in the submitted datasets for both hospitals. However, important deficits were identified in the accuracy of patient comorbidities. More specific and clear data definitions, and a more thorough examination of medical records would be possible methods to improve the accuracy of deficient areas.

【 授权许可】

   
2014 Seagrave et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Graves SE, Davidson D, Ingerson L, Ryan P, Griffith EC, McDermott BFJ, McElroy HJ, Pratt NL: The Australian Orthopaedic Association National Joint Replacement Registry. Med J Aust 2004, 180(5 Suppl):S31-S34.
• [2]Choong PFM: The challenges of joint replacement surgery in the 21st century. ANZ J Surg 2009, 79(10):669-671.
• [3]Brooks R: EuroQol: the current state of play. Health Policy 1996, 37(1):53-72.
• [4]Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, Dawson J: The use of the Oxford hip and knee scores. J Bone Joint Surg 2007, 89-B(8):1010-1014.
• [5]Robertsson O, Knutson K, Lewold S, Lidgren L: The Swedish Knee Arthroplasty Register 1975–1997: An update with special emphasis on 41,223 knees operated on in 1988–1997. Acta Orthopaedica Scandinavia 2001, 72(5):503-513.
• [6]Kärrholm J: The Swedish Hip Arthroplasty Register ( www.shpr.se ). Acta Orthop 2010, 81(1):3-4.
• [7]Provisional Monthly Patient Reported Outcome Measures (PROMs) in England - A guide to PROMs methodology. 2013.
• [8]Evans S, Bohensky M, Cameron P, McNeil J: A survey of Australian clinical registries: can quality of care be measured? Intern Med J 2011, 41(1a):42-48.
• [9]Kolling C, Simmen BR, Labek G, Goldhahn J: Key factors for a successful National Arthroplasty Register. J Bone Joint Surg 2007, 89(8):1567-1573.
• [10][http://www.bhi.nsw.gov.au/publications/local_hospital_performance] webcite Bureau of Health Information: Local Hospital Performance []
• [11]Altman DG: Practical Statistics for Medical Research. Chapman & Hall, London; 1991.
• [12]Viera AJ, Garrett JM: Understanding interobserver agreement: the kappa statistic. Fam Med 2005, 37(5):360-363.
• [13]Herbert MA, Prince SL, Williams JL, Magee MJ, Mack MJ: Are unaudited records from an outcomes registry database accurate? Ann Thorac Surg 2004, 77(6):1960-1964.
• [14]Rosner B: Fundamentals of Biostatistics. Duxbury Press, Belmont, CA; 2005.
• [15]Barrie JL, Marsh DR: Quality of data in the Manchester orthopaedic database. Br Med J 1992, 304:159-162.
• [16]Thoburn KK, German RR, Lewis M, Nichols P, Ahmed F, Jackson-Thompson J: Case completeness and data accuracy in the Centers for Disease Control and Prevention’s National Program of Cancer Registries. Cancer 2007, 109(8):1607-1616.
• [17]Laustsen J, Jensen LP, Hansen AK: Accuracy of clinical data in a population based vascular registry. Eur J Vasc Endovasc Surg 2004, 27(2):216-219.