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At least 19 recordsLinked to original sources

Individual cigarette usage: self-reported data as a function of respondent-reported data.

The interview method was used to collect data from living respondent-subject pairs regarding cigarette usage of the subject; the nonsmoker subject was explicitly not studied. Several different measures of usage were tested. The mean correlation coefficient between subject-reported data and the corresponding respondent-reported data was 0.86; that is, at least 70% of the variability in subject-reported data can be accounted for from information obtained from an appropriate living respondent closely associated with the subject. Selected regression equations are presented for estimating cigarette usage of a subject from data provided by a respondent.

Adolescent↗

Ulcerogenicity of piroxicam: an analysis of spontaneously reported data.

Previous reports have suggested that piroxicam may be more ulcerogenic than other non-steroidal anti-inflammatory drugs (NSAIDs) in use. Critics have attributed this putative relation to flawed comparisons of spontaneously reported data. In this study cases of upper gastrointestinal bleeding, perforation, and ulcer reported to the Food and Drug Administration's spontaneous reporting system over 12 years were examined. Reporting rates for eight NSAIDs were compared over identical periods of their marketing life cycles. After adjustments were made for the heterogeneity in the underlying reporting rates the difference in rates between piroxicam and the other drugs was considerably reduced but piroxicam retained its top ranking among the drugs; however, large and clinically important differences in the frequency of cases of upper gastrointestinal bleeding, perforation, and ulcer between piroxicam and the rest of the NSAIDs compared probably do not exist.

Anti-Inflammatory Agents, Non-Steroidal↗

Capturing momentary, self-report data: a proposal for reporting guidelines.

Self-report data are ubiquitous in behavioral and medical research. Retrospective assessment strategies are prone to recall bias and distortion. New techniques for assessing immediate experiences in respondents' natural environments (e.g., Ecological Momentary Assessment, Experience Sampling) are being used by many researchers to reduce reporting bias. This article discusses seven aspects of momentary research that are often overlooked or minimized in the presentation of momentary research reports, yet that are critical to the success of the research: (a) the rationale for the momentary sampling design, (b) the details of momentary sampling procedures, (c) the data acquisition interface, (d) rates of compliance with the sampling plan, (e) the procedures used to train and monitor participants, (f) data management procedures, and (g) the data analytic approach. Attention to these areas in both the design and reporting of momentary research studies will not only improve momentary research protocols but also allow for the successful replication of research findings by other investigators.

Guidelines as Topic↗

Comparison of urea reduction ratio and hematocrit data reported in different data systems: results from the Centers for Medicare & Medicaid Services and the Renal Network Inc.

BACKGROUND: Urea reduction ratio (URR) and hematocrit values reported on the Centers for Medicare & Medicaid Services (CMS) claims were compared with data from two different databases. METHODS: URRs and hematocrits from two different CMS databases (National Claims History and End-Stage Renal Disease Clinical Performance Measures [CPM] Project) and one Network database (The Renal Network Data System [TRNDS]) were compared for October through December 1998 and December 1998, respectively. A sample of records from the regional database was validated by independent chart review. RESULTS: Nationally, the percentage of agreement for patients with URRs of 65% or greater and less than 65% was 94% (kappa, 0.81; 95% confidence interval [CI], 0.80 to 0.83); regionally, the percentage of agreement was 95% (kappa, 0.85; 95% CI, 0.84 to 0.86). Nationally, linear regression of hematocrit values from both data sources yielded r(2) congruent with 0.61 each month and r(2) = 0.70 for average values during the 3-month study period. Nationally, the percentage of agreement for patients with hematocrits of 33% or greater and less than 33% was 84% (kappa approximately 0.66) each month. Regionally, linear regression of monthly hematocrit values from both data sources yielded r(2) = 0.66, and percentage of agreement for patients with hematocrits of 33% or greater and less than 33% was 87% (kappa, 0.71; 95% CI, 0.70 to 0.73). Validation of a sample of records in the TRNDS database resulted in 98% agreement for patients with URRs of 65% or greater and less than 65% and 96% agreement for patients with hematocrits of 33% or greater and less than 33%. CONCLUSION: Although there is general agreement between clinical variables submitted on the claims and in the CPM Project, some variation exists. Data from either source yield the same information when classifying patients as above or below threshold values.

Anemia↗

Validity of self reported data on injury prevention behavior: lessons from observational and self reported surveys of safety belt use in the US.

OBJECTIVES: To examine the validity of self reported data on safety belt use and to consider the implications for research on injury prevention behaviors. METHODS: 1992 and 1993 self reported data on safety belt use were obtained from the Behavioral Risk Factor Surveillance System and observational data were obtained from the National Highway Traffic Safety Administrations for 49 states in 1992 and 50 states in 1993. The ratio of self reported to observed belt use was calculated for each state, and linear regression models were used to examine the association between the two methods. RESULTS: There was variation between states, but the overall median ratio of self reported to observed safety belt use was 1.05 in 1992 (interdecile range 0.87-1.36) and 1.02 in 1993 (interdecile range 0.87-1.31). Self reports were substantially higher in southern states and in states with the lowest levels of observed use. Linear regression models indicated a moderately strong association between state estimates using both methods. For every percentage point increase in self reported data in 1993, observed safety belt use increased by 0.95 percentage point. CONCLUSIONS: In the aggregate, self reported estimates were only 2% to 5% higher than observed estimates. This is a substantial improvement from previous studies. This is probably due to the increased prevalence of safety belt use and the declining effects of social desirability on self reported use. In general, the validity of self reported estimates of socially desirable injury prevention behaviors will be higher when the actual prevalence of the behavior is higher, but lower when this is not true.

Accident Prevention↗

Comparing claims data and self-reported data with the medical record for Pap smear rates.

The objective of this study was to assess and compare the relative accuracy of claims data and patient self-reported information with medical records for Pap smear rates. A retrospective analysis of information obtained from administrative claims files, patient medical records, and a telephone survey was performed of 400 women age 19 through 75 years who were randomly selected for participation in the study. The data were obtained from a large multispecialty group practice in Minneapolis, Minnesota for the study years 1991 through 1993. Information from administrative claims regarding Pap smear status corresponded highly with information in the medical record (sensitivity 95% or higher; specificity 95% or higher; kappa 0.896 or better). Self-reported information from the telephone survey did not correspond well with medical record information nor with results in administrative claims.

Adult↗

Research ethics: ethical issues of data reporting and the quest for authenticity.

The search for truth and its unbiased reporting are ultimate goals of conducting scientific research. Ideally, the reporting of research data ought to be an objective task. In practice, however, it is fraught with numerous statistical and ethical pitfalls, seldom addressed in formal emergency medicine training. The lure of academic celebrity and related influences may persuade researchers to report results in ways that make data appear more interesting, or worthy of publication. Several examples of potentially misleading data reporting are illustrated, including using inappropriate statistical tests, neglecting negative results, omitting missing data points, failing to report actual numbers of eligible subjects, using inappropriate graph labels or terminology, data dredging, and others. Although potentially inaccurate or inflated methods of data reporting may not constitute overt scientific misconduct, the intentional misrepresentation of data is a form of fraud or deception. Publicly funded academic inquiry is a privilege and honor enjoyed by a trusted few. Regardless of outcome, every effort should be made to report data in the most scientifically accurate method. To this end, the Society for Academic Emergency Medicine Code of Conduct and American College of Emergency Physicians Code of Ethics provide important guidance toward the accurate, compassionate, competent, impartial, and honest conduct of scientific research. Accuracy and authenticity in data reporting are first and foremost a matter of individual integrity, and are crucial to the preservation of academic credibility, the protection of future patients, and the public's trust in the medical research enterprise.

Emergency Medicine↗

A survey of report writing by neuropsychologists, II: test data, report format, and document length.

Data are presented regarding current practices in the organization of neuropsychological reports, based on a representative sample of 414 US members of Division 40 of the American Psychological Association. The vast majority of the sample included some numeric test data in their reports, either within the text or as an addendum. The nature of the most predominant age groups and diagnostic categories served by neuropsychologists was of prominent influence on variables such as the frequency of utilization of age- and grade-equivalent scores, the inclusion of specific diagnostic codes, the provision of narrative recommendations, and the practice of deferring report distribution until after review with the patient or family. In addition, greater involvement with forensic evaluations in a medicolegal context through private practice tended to increase length of reports. It is concluded that, although there are many areas of consensus in the field with regard to the organization of neuropsychological reports, the final product needs to be shaped on the basis of consideration of the clinical presentation of the patient as well as the needs and knowledge base of the target audience.

Adolescent↗

Health system creates brand identity with clinical paths, outcomes data, report cards.

Using data to woo consumers: A four-hospital system in southern California is aggressively capturing and touting systemwide data in an effort to directly reach consumers with the message that health care is of consistently high quality across the system. A systemwide report card doesn't even break the data out by hospital but instead is an attempt to "brand" health care. Here's the story, plus some unique data charts from the consumer report card.

Benchmarking↗

The impact of outcomes data reporting on access to health care of high-risk patients to interventional cardiologists in the United States.

BACKGROUND: Pressure is increasingly being placed on medical sub-specialists to lower procedural costs while improving overall outcomes. Outcomes data reporting has been utilized in an attempt to improve procedural results; however, some negative aspects of this type of reporting have emerged. METHODS: We surveyed 5,229 interventional cardiologists practicing in the United States regarding the effect of outcomes data reporting on their approach to high-risk patients who required interventional procedures. The results were analyzed one month after mailing the survey. RESULTS: One thousand, four hundred and forty-four cardiologists responded to the survey. Ninety-three percent of the respondents indicated that outcomes data reporting would have some effect on their approach to high-risk patients. Only 7% said outcomes reporting would have no effect on their willingness to perform interventions on high-risk patients. The majority of respondents performed between 51 and 100 interventions per year; those who performed more than 500 interventions per year reported that they would be less affected if outcomes data were reported from their results. CONCLUSIONS: Our survey indicates that outcomes data reporting would have a significant effect on the willingness of cardiologists to perform procedures on high-risk patients; this effect may limit access to needed care for this high-risk population.

Angioplasty, Balloon, Coronary↗

Concordance of self-reported data and medical record audit for six cancer screening procedures.

BACKGROUND: Self-reported data about the interval since last cancer screening are often used to determine whether individuals are due for periodic screening and to monitor adherence to guidelines for early cancer detection. PURPOSE: In a study conducted within the Kaiser Permanente Medical Care Program, we examined the concordance of self-reported information and medical record documentation about recency of and reasons for six procedures for early cancer detection. We also assessed the concordance of population-level estimates of screening rates based on these two sources. METHODS: Data were obtained from a mailed questionnaire or telephone interview completed by 779 men and women. The data from these randomly selected study participants (431 women and 348 men), who had been members of the health plan for the previous 5 years, were compared with information obtained from their medical charts. Intersource agreement about whether each procedure was done within the last 2 years was evaluated, with the medical record used as the gold standard. To assess the accuracy of patient self-reporting, we also calculated sensitivity, false-positive and false-negative results, and Kappa statistics. RESULTS: Concordance between self-reported data and medical record documentation was greater for procedures that generated a test report (mammogram, Pap smear, fecal occult blood test, and sigmoidoscopy) than for those generating a physician's note (clinical breast examination and digital rectal examination). Kappa statistics showed a similar pattern. Sensitivity of self-reported data was more than 90% for mammogram, clinical breast examination, Pap smear, and fecal occult blood test and nearly 80% for sigmoidoscopy and digital rectal examination. However, false-positive results were above 40%, except for fecal occult blood test and sigmoidoscopy. For all six procedures, estimated population-level rates of screening within the past 2 years would have been significantly higher (P < .0001) if self-reported data were used instead of medical record audit data. CONCLUSIONS: Self-reported data may overestimate the percentage of the population that has been screened and underestimate the interval since the last cancer detection procedures. IMPLICATIONS: Such data should be used cautiously for clinical decision making, research, and surveillance activities at both individual and population levels. Also, comparability of data should be considered when population screening rates are evaluated on the basis of different data sources.

Adult↗

Missouri's emergency department E-code data reporting: a new level of data resource for injury prevention and control.

This article describes the results of the first statewide external cause of injury (E-code) reporting system that includes emergency department (ED) visits. The results indicate that for every injury-related death, there are 20 hospitalizations and 174 ED visits. Although firearms and motor vehicle crashes were the leading causes of injury-related deaths, falls and motor vehicle crashes were the leading causes of ED visits. An analysis of injuries in one metropolitan statistical area in the state demonstrates similarities and differences from the statewide results. The statewide reporting of cause of injury information in ED visits provides valuable information for injury control efforts.

Adolescent↗

Latin American Registry of dialysis and renal transplantation: 1993 annual dialysis data report.

BACKGROUND: The Latin American Registry of Dialysis and Transplantation was created in October 1991 and comprises the National Societies of Nephrology from 21 countries with a total population of 468.56 million inhabitants. METHODS: This report includes data from 21,181 patients from Argentina, Brazil, Chile, El Salvador, Panama, Paraguay, Peru, Puerto Rico, Uruguay, and Venezuela who were receiving chronic dialysis treatment during 1993. Data was collected by individual patient questionnaires except from Chile and Brazil where the data was obtained from a local centre questionnaire. RESULTS: The prevalence rate averaged 131.1 per million population. The mean age of the 8972 incident patients was 50.5 years, with 58.2% males. The more frequent causes of renal failure were glomerulopathies (22.6%), vascular nephropathy (20.9%) and diabetes (16.9%). Haemodialysis was the most used treatment (88.3%). Gross mortality was 21.1% and the more frequent causes of death were cardiac complications and infections. The analysis of mortality risk factors using a logistic regression model showed that diabetics patients older than 65 years had the highest probability of death (43.0%) and patients with glomerulonephritis, younger than 65 years had the lowest (8.0%). The adjusted mortality rate was 241 deaths/1000 patient-years at risk when the USRDS 1987-1989 white mortality rate by age groups and primary diseases was used as standard. CONCLUSION: In spite of the economic difficulties, very important efforts have been made to treat ESRD patients and gross mortality statistics in some countries are similar to those reported by other regional registries.

Adolescent↗

Using self-reported data to predict expenditures for the health care of older people.

OBJECTIVES: To create and test a method for using self-reported data to predict future expenditures for the health care of older people. DESIGN: A two-stage regression model of the relationship between self-reported data and Medicare expenditures during the following year was constructed from a randomly selected (derivation) half of a cohort of fee-for-service Medicare beneficiaries. For the other (validation) half of the cohort, two sets of predictions of 12-month Medicare expenditures were generated, one using the new two-stage model and the other using the principal inpatient diagnostic cost group (PIP-DCG) method now used to risk-adjust capitation payments to Medicare + Choice health plans. Both sets of predictions were compared with Medicare's actual 12-month expenditures for the validation cohort. SETTING: Ramsey County, Minnesota. PARTICIPANTS: Community-dwelling Medicare beneficiaries aged 70 and older (N = 13,682) who responded to a mailed survey. MEASUREMENTS: Predicted-to-observed ratio (PTOR) of Medicare expenditures. RESULTS: For the validation cohort, Medicare's actual 12-month expenditures totaled $26.5 million. The two-stage model predicted Medicare expenditures of $26.4 million (PTOR = 1.00); the PIP-DCG method predicted $31.2 million (PTOR = 1.18). Within subpopulations of healthy and ill beneficiaries, the two-stage model's predictions remained considerably more accurate than the PIP-DCG predictions. CONCLUSION: Self-reported data may predict future Medicare expenditures more accurately than administrative data about beneficiaries' demographic characteristics, and previous hospitalizations.

Aged↗

Verification of data reported by practices for a study of spontaneous abortion.

Little is known about the accuracy of data reported in practice based primary care research. The Ambulatory Sentinel Practice Network (ASPN) undertook a 100% audit of 226 patients included in a study of spontaneous abortion (SAB). The audit was conducted to assess the feasibility of conducting audits in primary care research networks dispersed over large geographic areas, verify that patients met inclusion criteria, and assess the frequency of reporting errors using the medical record as a standard. Of the originally reported SABs, 24% could not be verified. The overall error rate was 4.5%, a total of 106 errors out of a possible 2,361. Seventy percent of these errors came from five of the 34 participating practices. Sixty-six percent of the records were error-free. Seventy-seven percent of the errors were associated with problems with methods and clustered into three categories: gravidity, gestational age, and dilation and curettage (D&C). According to this audit, the data reported by the practices for research purposes were very similar to the data found in the medical record.

Abortion, Spontaneous↗