Use of Statewide Administrative Data to Assess Clinical Outcomes
| Autor: | Garth H. Utter, Richard H. White, Daniel J. Shouldice, Beate Danielsen, Edgardo S. Salcedo, Misty D. Humphries, Tejveer S. Dhillon |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Research design Databases Factual Outcome Assessment Deep vein Cardiovascular California Cohort Studies 0302 clinical medicine administrative data Risk Factors Outcome Assessment Health Care Odds Ratio 030212 general & internal medicine 030503 health policy & services Medical record Venous Thromboembolism Hematology Middle Aged Pulmonary embolism medicine.anatomical_structure Lower Extremity Organization and Administration Ambulatory Public Health and Health Services Health Policy & Services Female Patient Safety 0305 other medical science Adult medicine.medical_specialty international classification of diseases venous thromboembolism Article Databases 03 medical and health sciences Clinical Research medicine Humans Factual Retrospective Studies Aged Quality of Health Care deep venous thrombosis business.industry Public Health Environmental and Occupational Health Anticoagulants Retrospective cohort study Odds ratio Emergency department medicine.disease Health Care Applied Economics Emergency medicine isolated calf deep venous thrombosis business |
| Zdroj: | Medical care, vol 58, iss 7 Med Care |
| ISSN: | 0025-7079 |
| Popis: | Background Single-center comparative effectiveness studies evaluating outcomes that can occur posthospitalization may become biased if outcomes diagnosed at other facilities are not ascertained. Administrative datasets that link patients' records across facilities may improve outcome ascertainment. Objective To determine whether use of linked administrative data significantly augments thromboembolic outcome ascertainment. Research design Retrospective cohort study. Subjects Patients with an acute isolated calf deep vein thrombosis (DVT) diagnosed at 1 Californian center during 2010-2013. Measures Proximal DVT or pulmonary embolism (PE) within 180 days. We ascertained outcomes from linked California hospitalization, emergency department, and ambulatory surgery data and compared this information to outcomes previously identified from review of the center's medical records. Results Among 384 patients with an isolated calf DVT, 333 could be linked to longitudinal administrative data records. Ten patients had a possible proximal DVT or PE (4 more clearly so) from administrative data; all were unknown from medical record review. Eleven patients with known outcomes from medical record review had no outcome from administrative data. The adjusted odds ratio of proximal DVT or PE with therapeutic anticoagulation attenuated from 0.33 [95% confidence interval (CI), 0.12-0.87] using only medical record review to 0.64 (95% CI, 0.29-1.40) using both medical record review and possible outcomes from administrative data. Restricting the outcome to diagnoses clearly involving proximal DVT or PE, the adjusted odds ratio was 0.46 (95% CI, 0.19-1.10). Conclusions Use of linked hospital administrative data augmented detection of outcomes but imperfect linkage, nonspecific diagnoses, and documentation/coding errors introduced uncertainty regarding the accuracy of outcome ascertainment. |
| Databáze: | OpenAIRE |
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