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PubMed1994

The emerging role of the health information management professional in data quality and analysis of an electronic medical record system.

The role of the health information management professional is changing with the advancement of the electronic medical record system (EMRS) and electronic financial database systems. The Medical ARchival System, a longitudinal EMRS developed at the University of Pittsburgh Medical Center, was used to describe the methodology that the health information management professional should use when performing data quality evaluations and data analysis of an EMRS. Specific examples of steps used to integrate databases to collect the data and generate appropriate reports and tables are also described and discussed.

Academic Medical Centers↗
PubMed2002

Microarray data quality analysis: lessons from the AFGC project. Arabidopsis Functional Genomics Consortium.

Genome-wide expression profiling with DNA microarrays has and will provide a great deal of data to the plant scientific community. However, reliability concerns have required the development data quality tests for common systematic biases. Fortunately, most large-scale systematic biases are detectable and some are correctable by normalization. Technical replication experiments and statistical surveys indicate that these biases vary widely in severity and appearance. As a result, no single normalization or correction method currently available is able to address all the issues. However, careful sequence selection, array design, experimental design and experimental annotation can substantially improve the quality and biological of microarray data. In this review, we discuss these issues with reference to examples from the Arabidopsis Functional Genomics Consortium (AFGC) microarray project.

Arabidopsis↗
PubMed1995

Data quality after restructuring a national medical registry.

The validity of the 1991 Finnish Medical Birth Registry data was assessed, with special emphasis on the effects of changes made to the data collection form in 1990. Data abstracted from medical records for all births occurring in 49 hospitals during a five-day sample period (n = 865) were compared to the register information. Good or satisfactory validity was found for 32 of 33 variables, when minor error was tolerated in variables with continuous scales. For diagnoses and procedures, recorded in check-box format, satisfactory validity was found for 10 of 45 variables. Validity could not be assessed for 18 variables because of insufficient number of cases (13 items) or definition problems (5 items). When the results were compared to a 1987 data quality study, many of the variables that had been changed to the check-box format showed improvement in validity. In addition, in some cases a small change in question alternatives or instructions caused a noticeable change in validity.

Abstracting and Indexing↗
PubMed2000

The amyotrophic lateral sclerosis assessment questionnaire (ALSAQ-40): tests of data quality, score reliability and response rate in a survey of patients.

OBJECTIVES: To evaluate response rate, data quality, and score reliability of the 40 item Amyotrophic Lateral Sclerosis Assessment Questionnaire in a survey of MND patients. DESIGN: A survey of members of the MND Association of the UK, of which half were randomly allocated to receive a survey instrument from the MND Association and the other half allocated to receive the MND Association survey instrument and also the ALSAQ-40 questionnaire. SAMPLE: Five hundred patients were randomly selected from the membership lists of the MND Association, of whom 250 received the MND Association Survey and the ALSAQ-40. RESULTS: Response rate to the survey was 59.2%. Over half of the respondents received the ALSAQ-40. Data for individual items were analysed and found to be distributed across all response categories. All items were found to be highly associated with the scales to which they contribute. Internal consistency reliability of all the five scales of the ALSAQ-40 was also found to be high. CONCLUSION: Inclusion of the ALSAQ-40 into the survey did not have an adverse effect upon response rates. Furthermore, the ALSAQ-40 was shown to have highly desirable psychometric properties. This paper provides further evidence of the reliability and validity of the measure.

Adult↗
PubMed1995

[The national patient registry. Evaluation of data quality].

The Danish National Patient Register, which includes information on all patients admitted to hospitals, has been evaluated as concerns the quality of the data included. The material examined consisted of a representative sample of 1094 patients from departments all over the country (gynaecology and obstetrics, medicine, surgery and paediatrics). Recoding of data, clinical as well as administrative, based on copies of the case records from the hospitals was carried out by two clinically working physicians (registrars). For the administrative data e.g. length of stay, satisfactory concordance was found. The validity of clinical information depended on clinical speciality and degree of diagnostic specificity. Based on the international classification the agreement on the three digit diagnostic level was better than on the five digit diagnostic level. For surgery the agreement was better than for medicine. The agreement between the diagnostic information (primary diagnosis) and the recoder in choosing primary diagnosis varied from 66-83 percent on the five digit level and between 73-89 percent on the three digit diagnostic level. If cases where the diagnosis in the registry could be regarded as an acceptable alternative were included, the agreement between the registry and recoding was 75-90%. In a subsample of the material double coding by the two coders was carried out and it was remarkable that, taken as a whole, the degree of agreement between the two coders was of the same size as between recoder and the registry. It is anticipated, however, that introduction of ICD-10 with more clear-cut rules for choice of primary diagnosis in morbidity coding will contribute to better validity and consequently improved hospital statistics.

Denmark↗
PubMed1989

Ensuring data quality in a multicenter clinical trial: remote site data entry, central coordination and feedback.

In an ongoing multicenter clinical trial, "Treatment Strategies in Schizophrenia," the five participating sites have the capacity to perform a variety of tasks or study functions independently. These tasks include (a) verification of diagnostic eligibility through the use of computerized decision algorithms; (b) assignment of patients to treatment based on prognostic indicators using a computerized randomization algorithm; (c) entry of data into a microcomputer using a clinical trial data management system that performs simple range and missing data item checks; and (d) regular transfer of all data to the central coordinating team. The clinical trial data management system employed allows for both independent site functioning and assurance of consistency across sites. The integration of a variety of software outside the main data management system provides the central coordinators with the tools to monitor critical data as it is collected, as well as the capacity to assess the flow, quality, and uniformity of the ongoing trial.

Clinical Trials as Topic↗
PubMed2002

Data quality in evaluation of an alcohol-related harm prevention program.

The authors report the reliability and convergent validity in a sample of college students for 27 composite scales and two items covering alcohol use, cigarette smoking, marijuana use, and other drug use; beliefs relating to alcohol use; perceived norms for alcohol-related behavior; harm prevention skills; intentions to take prevention action; harm prevention action taken; risk taken; experienced harm; and other health-related behaviors and person characteristics. Data quality assessment strategies and missing data procedures were illustrated for large, multivariate, longitudinal data sets. Results indicate 23 of the 27 composite scales had at least acceptable reliability, and the remaining 4 composite scales had at least marginally acceptable reliability. At least moderate construct validity was demonstrated for 25 scales.

Adult↗
PubMed1985

Clinical data quality: impact on revenue.

In large measure, individual hospitals' survival and growth in a prospective payment environment depend on management's abilities to develop both an aggressive strategic plan and short-term monitoring systems to ensure the quality of the clinical data. In general, managers should capitalize on factors favorable to the hospital, minimize the impact of unfavorable factors, and position the organization to respond favorably to expect future changes. To accomplish these three goals, the quality of the clinical data must be analyzed and linked to revenue expectations. Then, if needed, the next step is to implement short-term actions to improve any data deficiencies that are identified. In this way, the hospital's clinical data, which are an accurate reflection of services rendered, can be used with confidence for long-term strategic and financial planning.

Data Collection↗
PubMed1996

Analyses of data quality in registries concerning diabetes mellitus--a comparison between a population based hospital discharge and an insulin prescription registry.

To evaluate the data quality in the Danish National Registry of Patients (DNRP) and the Prescription Registry in the country of Northern Jutland (487,000 inhabitants) concerning insulin dependent diabetes mellitus (IDDM) and insulin treated diabetes mellitus, a comparison between data in the two registries was made. From the Regional Hospital Registry in the County of Northern Jutland, containing discharge diagnoses from all admissions to hospitals in the county, we identified all patients with the IDDM diagnosis between 1987 and 1993. From the Regional Prescription Registry all insulin prescriptions taken up at pharmacies in the county in 1993 were identified. All persons were identified by their individual identification number (CPR-number), and a record linkage between the two data sources was made. The predictive value of an IDDM-registration in the DNRP was 96% and the corresponding completeness 91%. In the Prescription Registry the completeness was 96%. Both registries seem to be valuable study bases for epidemiological research in diabetes mellitus.

Denmark↗
PubMed1991

Employers making use of price, quality data.

In efforts they hope will reduce costs, healthcare purchasers are becoming more active in helping beneficiaries choose providers. Such efforts include increased use of widely available price and quality data. Quaker Oats, for example, publishes hospital price guides, while Navistar International and Hershey Foods are developing their own provider networks.

Community Participation↗
PubMed1994

Data quality in a DRG-based information system.

The aim of this study initiated in May 1990 was to evaluate the quality of the medical data collected from the main hospital of the "Hospices Civils de Lyon", Edouard Herriot Hospital. We studied a random sample of 593 discharge abstracts from 12 wards of the hospital. Quality control was performed by checking multi-hospitalized patients' personal data, checking that each discharge abstract was exhaustive, examining the quality of abstracting, studying diagnoses and medical procedures coding, and checking data entry. Assessment of personal data showed a 4.4% error rate. It was mainly accounted for by spelling mistakes in surnames and first names, and mistakes in dates of birth. The quality of a discharge abstract was estimated according to the two purposes of the medical information system: description of hospital morbidity per patient and Diagnosis Related Group's case mix. Error rates in discharge abstracts were expressed in two ways: an overall rate for errors of concordance between Discharge Abstracts and Medical Records, and a specific rate for errors modifying classification in Diagnosis Related Groups (DRG). For abstracting medical information, these error rates were 11.5% (SE +/- 2.2) and 7.5% (SE +/- 1.9) respectively. For coding diagnoses and procedures, they were 11.4% (SE +/- 1.5) and 1.3% (SE +/- 0.5) respectively. For data entry on the computerized data base, the error rate was 2% (SE +/- 0.5) and 0.2% (SE +/- 0.05). Quality control must be performed regularly because it demonstrates the degree of participation from health care teams and the coherence of the database.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗
PubMed1986

Design and data quality of a mixed longitudinal study to elucidate the role of dietary calcium and phosphorus on bone mineralization in pre-, peri-, and postmenopausal women.

The study design and data quality control of an ongoing study (10 yr duration) in a few hundred women are presented. Good variables with respect to their longitudinal usefulness are: body weight, body height, and span-width. Reasonable variables are the bone parameters of the radius (BMC, BW, and BMC/BW). Poor variables are: dietary calcium and phosphorus intake, dietary calcium-to-phosphorus ratio, urinary calcium-to-creatinine ratio, urinary sodium-to-creatinine ratio, hematocrit, serum alkaline phosphatase activity, serum gamma-GT activity, and serum parathyroid-hormone concentration. Bad variables are: urinary phosphorus-to-creatinine ratio, urinary hydroxyproline-to-creatinine ratio, creatinine clearance, hemoglobin, MCHC, serum calcium, serum ionized calcium, serum phosphorus, serum total protein, serum albumin, and serum creatinine. In conclusion, it is possible to relate bone loss to food intake and to changes in anthropometric variables on an individual basis. However, quantification of the metabolic process is not possible.

Anthropometry↗
PubMed1985

Data quality and DRGs: an assessment of the reliability of federal beneficiary discharge data in selected Manhattan hospitals.

New York County Health Services Review Organization (NYCHSRO), the physicians' professional standards review organization of Manhattan, examined whether diagnostic coding errors identified in Manhattan hospitals would affect reimbursement under a diagnostic-related group (DRG) method of financing inpatient services. A sampling of 1,027 Medicare and Medicaid cases representing discharges from 18 Manhattan hospitals during 1982 and 1983 revealed incorrect DRG assignment for 17.5% of patient record abstracts, but these appear to have been unsystematic rather than deliberate errors. The difference between estimated reimbursement based on original and reabstracted records was not statistically significant either in the aggregate or for specific hospitals. It is emphasized that while New York State's Prospective Hospital Reimbursement Methodology (in effect during the study period) is not solely dependent upon DRG's case-mix is one of several factors used to make adjustments to existing per diem rates. A key recommendation is that hospitals conduct internal monitorings with all involved departments to improve the quality of the data abstracting process.

Diagnosis-Related Groups↗
PubMedDate not supplied

Outpatient satisfaction: validation of a French-language questionnaire: data quality and identification of associated factors.

OBJECTIVES: Following 1996 legislation requiring French hospitals to assess patient satisfaction, this study developed and validated a brief French-language multidimensional questionnaire designed to measure outpatient satisfaction with hospital visits and compared data quality for two patient-satisfaction survey methods. DESIGN: Authors developed a 19-item questionnaire following a strict procedure (identification of dimensions to explore, formulation, and selection of items). SETTING: Validation data were obtained from patients of six outpatient clinics in a teaching hospital. PARTICIPANTS: 586 consenting eligible patients were randomized to receive the questionnaire 2 weeks after their visit with one of two survey methods: a mailed self-administered questionnaire or a telephone interview. RESULTS: The response rate (79%) was not significantly different between the two survey methods. The risk of having one or more missing values was higher in the mail survey group (odds ratio, 1.65; 95% confidence interval, 1.03-2.63), but mail respondents were less likely to use the "extremely positive" response category. Principal component analysis identified four factors that accounted for 56% of the variance: interpersonal skills and information transfer, physical surroundings, convenience, and appointment delay. Patients' comments on open-ended questions validated the semantic content of the factorial construct. The internal consistency coefficient was greater than 0.70 for three of four subscales. Patient background characteristics accounted for less than 10% of the factorial score variance. Patient satisfaction was correlated with age, type of visit, and, to a lesser extent, gender and education level. CONCLUSION: This easily administered, multidimensional out-patient-satisfaction questionnaire provided encouraging preliminary psychometric characteristics.

Adolescent↗
PubMed1999

Follow-up procedures in EPIC-Germany--data quality aspects. European Prospective Investigation into Cancer and Nutrition.

With 475,000 participants throughout Europe, EPIC is one of the largest cohort studies investigating the association between diet and cancer and other chronic diseases. The German part of EPIC comprises about 53,000 participants in Potsdam (n = 27,616) and in Heidelberg (n = 25,546). In the German study centers, follow-up started in 1998 and will be continued in 2-year intervals over the next 10-15 years. To ensure high follow-up data quality at an European level, an international working group developed guidelines for endpoint data collection in every country. A follow-up phase in Germany comprises mailing of a questionnaire, tracing of individuals to whom mail could not be delivered, obtaining information on deceased participants including cause of death, and verifying self- reported diagnoses. Furthermore, activities aimed at motivating study participants are part of the follow-up. The first round of follow-up of those who entered the study in 1994 and 1995 included 8, 706 participants in Potsdam and 6,289 in Heidelberg. Due to a comprehensive and intensive reminder and tracing system, vital status of the study subjects is known from almost 100% in Potsdam and 99% in Heidelberg. Two years after baseline examination, and with twice as many addresses in Potsdam as in Heidelberg, addresses had to be traced or checked via population registry (13 versus 6%). Tracing, the application of different mailing strategies, and intensive reminder activities resulted in a 95% return of the questionnaire in Potsdam and 90% in Heidelberg. The system of follow-up data entry and control, including completion of missing information via telephone, verification of self-reports and causes of death, has been set up for EPIC-Germany and works efficiently and successfully. The aim of this paper is to describe the follow-up procedures in EPIC-Germany with a focus on the generation of valid and complete outcome data.

Cohort Studies↗
PubMed1998

Vision 2006 brings data quality management into view.

One of the goals of the vision 2006 initiative has been to identify new career opportunities for HIM professionals. Recently, a group of AHIMA volunteers has provided a framework and tools for developing data quality management expertise. Here's an overview of their work and a look at resources for those who want to learn more.

Information Management↗