How accurate is the reporting of stroke in hospital discharge data? A pilot validation study using a population-based stroke registry as control
Identifieur interne : 000160 ( Pmc/Curation ); précédent : 000159; suivant : 000161How accurate is the reporting of stroke in hospital discharge data? A pilot validation study using a population-based stroke registry as control
Auteurs : Corine Aboa-Eboulé [France] ; Dominique Mengue [France] ; Eric Benzenine [France] ; Marc Hommel [France] ; Maurice Giroud [France] ; Yannick Béjot [France] ; Catherine Quantin [France]Source :
- Journal of Neurology [ 0340-5354 ] ; 2012.
Abstract
Population-based stroke registries can provide valid stroke incidence because they ensure exhaustiveness of case ascertainment. However, their results are difficult to extrapolate because they cover a small population. The French Hospital Discharge Database (FHDDB), which routinely collects administrative data, could be a useful tool for providing data on the nationwide burden of stroke. The aim of our pilot study was to assess the validity of stroke diagnosis reported in the FHDDB. All records of patients with a diagnosis of stroke between 2004 and 2008 were retrieved from the FHDDB of Dijon Teaching Hospital. The Dijon Stroke Registry was considered as the gold standard. The sensitivity, positive predictive value (PPV), and weighted kappa were calculated. The Dijon Stroke Registry identified 811 patients with a stroke, among whom 186 were missed by the FHDDB and thus considered false-negatives. The FHDDB identified 903 patients discharged following a stroke including 625 true-positives confirmed by the registry and 278 false-positives. The overall sensitivity and PPV of the FHDDB for the diagnosis of stroke were, respectively, 77.1 % (95 % CI 74.2–80) and 69.2 % (95 % CI 66.1–72.2). For cardioembolic and lacunar strokes, the FHDDB yielded higher PPVs (respectively 86.7 and 84.6 %;
Url:
DOI: 10.1007/s00415-012-6686-0
PubMed: 23076827
PubMed Central: 3566387
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A pilot validation study using a population-based stroke registry as control</title><author><name sortKey="Aboa Eboule, Corine" sort="Aboa Eboule, Corine" uniqKey="Aboa Eboule C" first="Corine" last="Aboa-Eboulé">Corine Aboa-Eboulé</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon</wicri:regionArea></affiliation></author><author><name sortKey="Mengue, Dominique" sort="Mengue, Dominique" uniqKey="Mengue D" first="Dominique" last="Mengue">Dominique Mengue</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon</wicri:regionArea></affiliation></author><author><name sortKey="Benzenine, Eric" sort="Benzenine, Eric" uniqKey="Benzenine E" first="Eric" last="Benzenine">Eric Benzenine</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Département d’Informatique Médicale, University Hospital of Dijon, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Département d’Informatique Médicale, University Hospital of Dijon, Dijon</wicri:regionArea></affiliation></author><author><name sortKey="Hommel, Marc" sort="Hommel, Marc" uniqKey="Hommel M" first="Marc" last="Hommel">Marc Hommel</name><affiliation wicri:level="1"><nlm:aff id="Aff4">CIC, CHU de Grenoble, La Tronche, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CIC, CHU de Grenoble, La Tronche</wicri:regionArea></affiliation></author><author><name sortKey="Giroud, Maurice" sort="Giroud, Maurice" uniqKey="Giroud M" first="Maurice" last="Giroud">Maurice Giroud</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff5">Service de Neurologie, CHU Dijon, BP 77908, 21079 Dijon CEDEX, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Dijon, BP 77908, 21079 Dijon CEDEX</wicri:regionArea></affiliation></author><author><name sortKey="Bejot, Yannick" sort="Bejot, Yannick" uniqKey="Bejot Y" first="Yannick" last="Béjot">Yannick Béjot</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon</wicri:regionArea></affiliation></author><author><name sortKey="Quantin, Catherine" sort="Quantin, Catherine" uniqKey="Quantin C" first="Catherine" last="Quantin">Catherine Quantin</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Département d’Informatique Médicale, University Hospital of Dijon, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Département d’Informatique Médicale, University Hospital of Dijon, Dijon</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">INSERM U666, University of Burgundy, Dijon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM U666, University of Burgundy, Dijon</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Neurology</title><idno type="ISSN">0340-5354</idno><idno type="eISSN">1432-1459</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Population-based stroke registries can provide valid stroke incidence because they ensure exhaustiveness of case ascertainment. However, their results are difficult to extrapolate because they cover a small population. The French Hospital Discharge Database (FHDDB), which routinely collects administrative data, could be a useful tool for providing data on the nationwide burden of stroke. The aim of our pilot study was to assess the validity of stroke diagnosis reported in the FHDDB. All records of patients with a diagnosis of stroke between 2004 and 2008 were retrieved from the FHDDB of Dijon Teaching Hospital. The Dijon Stroke Registry was considered as the gold standard. The sensitivity, positive predictive value (PPV), and weighted kappa were calculated. The Dijon Stroke Registry identified 811 patients with a stroke, among whom 186 were missed by the FHDDB and thus considered false-negatives. The FHDDB identified 903 patients discharged following a stroke including 625 true-positives confirmed by the registry and 278 false-positives. The overall sensitivity and PPV of the FHDDB for the diagnosis of stroke were, respectively, 77.1 % (95 % CI 74.2–80) and 69.2 % (95 % CI 66.1–72.2). For cardioembolic and lacunar strokes, the FHDDB yielded higher PPVs (respectively 86.7 and 84.6 %; <italic>p</italic> < 0.0001) than those of other stroke subtypes. The PPV but not sensitivity significantly increased over the years (<italic>p</italic> < 0.0001). Agreement with the stroke registry was moderate (kappa 52.8; 95 % CI 46.8–58.9). The FHDDB-based stroke diagnosis showed moderate validity compared with the Dijon Stroke Registry as the gold standard. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Neurol</journal-id><journal-id journal-id-type="iso-abbrev">J. Neurol</journal-id><journal-title-group><journal-title>Journal of Neurology</journal-title></journal-title-group><issn pub-type="ppub">0340-5354</issn><issn pub-type="epub">1432-1459</issn><publisher><publisher-name>Springer-Verlag</publisher-name><publisher-loc>Berlin/Heidelberg</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23076827</article-id><article-id pub-id-type="pmc">3566387</article-id><article-id pub-id-type="publisher-id">6686</article-id><article-id pub-id-type="doi">10.1007/s00415-012-6686-0</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Communication</subject></subj-group></article-categories><title-group><article-title>How accurate is the reporting of stroke in hospital discharge data? A pilot validation study using a population-based stroke registry as control</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Aboa-Eboulé</surname><given-names>Corine</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Mengue</surname><given-names>Dominique</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Benzenine</surname><given-names>Eric</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Hommel</surname><given-names>Marc</given-names></name><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Giroud</surname><given-names>Maurice</given-names></name><address><email>maurice.giroud@chu-dijon.fr</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Béjot</surname><given-names>Yannick</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Quantin</surname><given-names>Catherine</given-names></name><address><email>catherine.quantin@chu-dijon.fr</email></address><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref></contrib><aff id="Aff1"><label></label>Stroke Registry of Dijon, EA 4184, University Hospital and Faculty of Medicine of Dijon, STIC-Santé, University of Burgundy, Dijon, France</aff><aff id="Aff2"><label></label>Département d’Informatique Médicale, University Hospital of Dijon, Dijon, France</aff><aff id="Aff3"><label></label>INSERM U666, University of Burgundy, Dijon, France</aff><aff id="Aff4"><label></label>CIC, CHU de Grenoble, La Tronche, France</aff><aff id="Aff5"><label></label>Service de Neurologie, CHU Dijon, BP 77908, 21079 Dijon CEDEX, France</aff></contrib-group><pub-date pub-type="epub"><day>18</day><month>10</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>18</day><month>10</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2013</year></pub-date><volume>260</volume><issue>2</issue><fpage>605</fpage><lpage>613</lpage><history><date date-type="received"><day>24</day><month>4</month><year>2012</year></date><date date-type="rev-recd"><day>21</day><month>9</month><year>2012</year></date><date date-type="accepted"><day>22</day><month>9</month><year>2012</year></date></history><permissions><copyright-statement>© The Author(s) 2012</copyright-statement></permissions><abstract id="Abs1"><p>Population-based stroke registries can provide valid stroke incidence because they ensure exhaustiveness of case ascertainment. However, their results are difficult to extrapolate because they cover a small population. The French Hospital Discharge Database (FHDDB), which routinely collects administrative data, could be a useful tool for providing data on the nationwide burden of stroke. The aim of our pilot study was to assess the validity of stroke diagnosis reported in the FHDDB. All records of patients with a diagnosis of stroke between 2004 and 2008 were retrieved from the FHDDB of Dijon Teaching Hospital. The Dijon Stroke Registry was considered as the gold standard. The sensitivity, positive predictive value (PPV), and weighted kappa were calculated. The Dijon Stroke Registry identified 811 patients with a stroke, among whom 186 were missed by the FHDDB and thus considered false-negatives. The FHDDB identified 903 patients discharged following a stroke including 625 true-positives confirmed by the registry and 278 false-positives. The overall sensitivity and PPV of the FHDDB for the diagnosis of stroke were, respectively, 77.1 % (95 % CI 74.2–80) and 69.2 % (95 % CI 66.1–72.2). For cardioembolic and lacunar strokes, the FHDDB yielded higher PPVs (respectively 86.7 and 84.6 %; <italic>p</italic> < 0.0001) than those of other stroke subtypes. The PPV but not sensitivity significantly increased over the years (<italic>p</italic> < 0.0001). Agreement with the stroke registry was moderate (kappa 52.8; 95 % CI 46.8–58.9). The FHDDB-based stroke diagnosis showed moderate validity compared with the Dijon Stroke Registry as the gold standard. However, its accuracy (PPV) increased with time and was higher for some stroke subtypes.</p></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Stroke</kwd><kwd>Registry</kwd><kwd>Hospital discharge data</kwd><kwd>Validation</kwd><kwd>Administrative data</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© Springer-Verlag Berlin Heidelberg 2013</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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