Unexpected discrepancies in hospital administrative databases can impact the accuracy of monitoring thyroid surgery outcomes in France

Autor: Antoine Duclos, Frederic Mercier, Jean-Louis Kraimps, Elliot J. Mitmaker, Nathalie Laplace, Frederic Sebag, Cyrille Colin, Jean-Christophe Lifante, Stéphanie Bourdy
Rok vydání: 2018
Předmět:
Male
Databases
Factual
Medical Doctors
Health Care Providers
030230 surgery
computer.software_genre
Pathology and Laboratory Medicine
Vascular Medicine
Infographics
Hospitals
University
0302 clinical medicine
Medicine and Health Sciences
Medicine
Prospective Studies
Medical Personnel
Prospective cohort study
Thyroid
Multidisciplinary
Database
Middle Aged
Charts
Hospitals
Data Accuracy
Professions
medicine.anatomical_structure
Treatment Outcome
030220 oncology & carcinogenesis
Surgery outcome
Thyroidectomy
Female
France
Anatomy
Vocal Cord Paralysis
Research Article
Adult
Funnel plot
Computer and Information Sciences
Endocrine System Procedures
Hypoparathyroidism
Science
MEDLINE
Surgical and Invasive Medical Procedures
Endocrine System
Hemorrhage
Postoperative Hemorrhage
03 medical and health sciences
Signs and Symptoms
Diagnostic Medicine
Physicians
Humans
Aged
Surgeons
business.industry
Data Visualization
Gold standard
Biology and Life Sciences
medicine.disease
Health Care
Health Care Facilities
People and Places
Population Groupings
business
Complication
computer
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 12, p e0208416 (2018)
ISSN: 1932-6203
Popis: ObjectiveTo determine the validity of hospital administrative databases compared to prospective collection of medical data assessing thyroid surgery complications.BackgroundAdministrative data are increasingly used to track surgical outcomes.MethodsAll patients undergoing thyroid surgery at three French university hospitals between April 2008 and April 2009 were prospectively included. Using diagnosis and procedural codes from hospital administrative database, we designed three indicators for measuring complications of thyroid surgery: recurrent laryngeal nerve palsy, postoperative hypoparathyroidism, and postoperative hemorrhage. Gold standard was obtained from a prospective collection of medical data after systematically screening each patient for the above-mentioned complications. Their ability to monitor surgical outcomes over time within individual hospitals was estimated using control charts. Spatial comparison between hospitals was performed by funnel plots.ResultsA total of 1909 patients were included. Complication rates extracted from administrative data were significantly lower compared to medical data (nerve palsy 2.4% vs. 6.7%, hypoparathyroidism 10.6% vs. 22.3%, pConclusionsThe ability of indicators extracted from administrative databases to measure thyroid surgery outcomes depends on the quality of underlying data coding. Validation in every center should be a prerequisite before implementing such metrics for tracking performance.
Databáze: OpenAIRE
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