Accuracy of co-morbidity data in patients undergoing abdominal wall hernia repair: a retrospective study
| Autor: | D. Arumugam, R. Deering, Ambareen Kausar, D. McEleney, J. Guirguis, Shahab Hajibandeh, G. Sheikh, A. Sreh, S. Dix, D. OShea, Ethan Toner, A. Evans, A. Kelly, A. Khan, A. El Muntasar, A. Shafiq |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Comorbidity Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Hernia 030212 general & internal medicine Herniorrhaphy Asthma Aged Retrospective Studies business.industry Abdominal Wall Records Retrospective cohort study Middle Aged medicine.disease Hernia repair United Kingdom Surgery Data Accuracy Hernia Abdominal Hospitalization 030220 oncology & carcinogenesis Chronic Disease Female business Kappa Kidney disease Abdominal surgery |
| Zdroj: | Hernia : the journal of hernias and abdominal wall surgery. 22(2) |
| ISSN: | 1248-9204 |
| Popis: | To determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of routinely collected co-morbidity data in patients undergoing abdominal wall hernia repair. All patients aged > 18 who underwent umbilical, para-umbilical, inguinal or incisional hernia repair between 1 January 2015 and 1 November 2016 were identified. All parts of the clinical notes were searched for co-morbidities by two authors independently. The following co-morbidities were considered: hypertension, ischaemic heart disease (IHD), diabetes, asthma, chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CVD), chronic kidney disease (CKD), hypercholesterolemia, obesity and smoking. The co-morbidities data from clinical notes were compared with corresponding data in hospital episode statistics (HES) database to calculate accuracy, sensitivity, specificity, PPV and NPV of HES codes for co-morbidities. To assess the agreement between clinical notes and HES data, we also calculated Cohen’s Kappa index value as a more robust measure of agreement. Overall, 346 patients comprising 3460 co-morbidity codes were included in the study. The overall accuracy of HES codes for all co-morbidities was 77% (Kappa: 0.13). When calculated separately for each co-morbidity, the accuracy was 72% (Kappa: 0.113) for hypertension, 82% (Kappa: 0.232) for IHD, 85% (Kappa: 0.203) for diabetes, 86% (Kappa: 0.287) for asthma, 91% (Kappa: 0.339) for COPD, 92% (Kappa: 0.374) for CVD, 94% (Kappa: 0.424) for CKD, 74% (Kappa: 0.074) for hypercholesterolemia, 71% (Kappa: 0.66) for obesity and 24% (Kappa: 0.005) for smoking. The overall sensitivity, specificity, PPV and NPV of HES codes were 9, 100, 100, and 77%, respectively. The results were consistent when individual co-morbidities were analyzed separately. Our results demonstrated that HES co-morbidity codes in patients undergoing abdominal wall hernia repair are specific with good positive predictive value; however, they have substandard accuracy, sensitivity, and negative predictive value. The presence of a relatively large number of false negative or missed cases in HES database explains our findings. Better documentation of co-morbidities in admission clerking proforma may help to improve the quality of source documents for coders, which in turn may improve the accuracy of coding. |
| Databáze: | OpenAIRE |
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