Carl van Walraven1, Peter Austin. 1. Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario K1Y 4E9, Canada. carlv@ohri.ca
Abstract
OBJECTIVE: The provision of health care frequently creates digitized data--such as physician service claims, medication prescription records, and hospitalization abstracts--that can be used to conduct studies termed "administrative database research." While most guidelines for assessing the validity of observational studies apply to administrative database research, the unique data source and analytical opportunities for these studies create risks that can make them uninterpretable or bias their results. STUDY DESIGN: Nonsystematic review. RESULTS: The risks of uninterpretable or biased results can be minimized by; providing a robust description of the data tables used, focusing on both why and how they were created; measuring and reporting the accuracy of diagnostic and procedural codes used; distinguishing between clinical significance and statistical significance; properly accounting for any time-dependent nature of variables; and analyzing clustered data properly to explore its influence on study outcomes. CONCLUSION: This article reviewed these five issues as they pertain to administrative database research to help maximize the utility of these studies for both readers and writers.
OBJECTIVE: The provision of health care frequently creates digitized data--such as physician service claims, medication prescription records, and hospitalization abstracts--that can be used to conduct studies termed "administrative database research." While most guidelines for assessing the validity of observational studies apply to administrative database research, the unique data source and analytical opportunities for these studies create risks that can make them uninterpretable or bias their results. STUDY DESIGN: Nonsystematic review. RESULTS: The risks of uninterpretable or biased results can be minimized by; providing a robust description of the data tables used, focusing on both why and how they were created; measuring and reporting the accuracy of diagnostic and procedural codes used; distinguishing between clinical significance and statistical significance; properly accounting for any time-dependent nature of variables; and analyzing clustered data properly to explore its influence on study outcomes. CONCLUSION: This article reviewed these five issues as they pertain to administrative database research to help maximize the utility of these studies for both readers and writers.
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