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How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care
BACKGROUND/AIMS: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke ris...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122989/ https://www.ncbi.nlm.nih.gov/pubmed/27750249 http://dx.doi.org/10.1159/000449288 |
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author | Porter, Joan Mondor, Luke Kapral, Moira K. Fang, Jiming Hall, Ruth E. |
author_facet | Porter, Joan Mondor, Luke Kapral, Moira K. Fang, Jiming Hall, Ruth E. |
author_sort | Porter, Joan |
collection | PubMed |
description | BACKGROUND/AIMS: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke risk factors, and the use of hospital-based diagnostic procedures in patients with stroke or TIA. METHODS: Medical charts for a population-based sample of patients (n = 14,508) with ischemic stroke, intracerebral hemorrhage (ICH), or TIA discharged from inpatient and emergency departments (ED) in Ontario, Canada, between April 1, 2012 and March 31, 2013, were audited by trained abstractors. Audited data were linked and compared with hospital administrative data and physician billing data. The positive predictive value (PPV) of hospital administrative data and kappa agreement for the reporting of stroke type were calculated. Kappa agreement was also determined for stroke risk factors and for select stroke-related procedures. RESULTS: The PPV for stroke type in inpatient administrative data ranged from 89.5% (95% CI 88.0-91.0) for TIA, 91.9% (95% CI 90.2-93.5) for ICH, and 97.3% (95% CI 96.9-97.7) for ischemic stroke. For ED administrative data, PPV varied from 78.8% (95% CI 76.3-81.2) for ischemic, 86.3% (95% CI 76.8-95.7) for ICH, and 95.3% (95% CI 94.6-96.0) for TIA. The chance-corrected agreement between the audited and administrative data was good for atrial fibrillation (k = 0.60) and very good for diabetes (k = 0.86). Hospital administrative data combined with physician billing data more than doubled the observed agreement for carotid imaging (k = 0.65) and echocardiography (k = 0.66) compared to hospital administrative data alone. CONCLUSIONS: Inpatient and ED administrative data were found to be reliable in the reporting of the International Classification of Diagnosis, 10th revision, Canada (ICD-10-CA)-coded ischemic stroke, ICH and TIA, and for the recording of atrial fibrillation and diabetes. The combination of physician billing data with hospital administrative data greatly improved the capture of some diagnostic services provided to inpatients. |
format | Online Article Text |
id | pubmed-5122989 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-51229892016-12-05 How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care Porter, Joan Mondor, Luke Kapral, Moira K. Fang, Jiming Hall, Ruth E. Cerebrovasc Dis Extra Original Paper BACKGROUND/AIMS: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke risk factors, and the use of hospital-based diagnostic procedures in patients with stroke or TIA. METHODS: Medical charts for a population-based sample of patients (n = 14,508) with ischemic stroke, intracerebral hemorrhage (ICH), or TIA discharged from inpatient and emergency departments (ED) in Ontario, Canada, between April 1, 2012 and March 31, 2013, were audited by trained abstractors. Audited data were linked and compared with hospital administrative data and physician billing data. The positive predictive value (PPV) of hospital administrative data and kappa agreement for the reporting of stroke type were calculated. Kappa agreement was also determined for stroke risk factors and for select stroke-related procedures. RESULTS: The PPV for stroke type in inpatient administrative data ranged from 89.5% (95% CI 88.0-91.0) for TIA, 91.9% (95% CI 90.2-93.5) for ICH, and 97.3% (95% CI 96.9-97.7) for ischemic stroke. For ED administrative data, PPV varied from 78.8% (95% CI 76.3-81.2) for ischemic, 86.3% (95% CI 76.8-95.7) for ICH, and 95.3% (95% CI 94.6-96.0) for TIA. The chance-corrected agreement between the audited and administrative data was good for atrial fibrillation (k = 0.60) and very good for diabetes (k = 0.86). Hospital administrative data combined with physician billing data more than doubled the observed agreement for carotid imaging (k = 0.65) and echocardiography (k = 0.66) compared to hospital administrative data alone. CONCLUSIONS: Inpatient and ED administrative data were found to be reliable in the reporting of the International Classification of Diagnosis, 10th revision, Canada (ICD-10-CA)-coded ischemic stroke, ICH and TIA, and for the recording of atrial fibrillation and diabetes. The combination of physician billing data with hospital administrative data greatly improved the capture of some diagnostic services provided to inpatients. S. Karger AG 2016-10-18 /pmc/articles/PMC5122989/ /pubmed/27750249 http://dx.doi.org/10.1159/000449288 Text en Copyright © 2016 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. |
spellingShingle | Original Paper Porter, Joan Mondor, Luke Kapral, Moira K. Fang, Jiming Hall, Ruth E. How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care |
title | How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care |
title_full | How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care |
title_fullStr | How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care |
title_full_unstemmed | How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care |
title_short | How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care |
title_sort | how reliable are administrative data for capturing stroke patients and their care |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122989/ https://www.ncbi.nlm.nih.gov/pubmed/27750249 http://dx.doi.org/10.1159/000449288 |
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