José Luis Bernal1, José A Barrabés2, Andrés Íñiguez3, Antonio Fernández-Ortiz4, Cristina Fernández-Pérez5, Alfredo Bardají6, Francisco Javier Elola7. 1. Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain. Electronic address: Jluis.bernal@movistar.es. 2. Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Vall d'Hebron, Institut de Recerca (VHIR), CIBER-CV, Universidad Autónoma de Barcelona, Barcelona, Spain. 3. Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain. 4. Servicio de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain; Fundación Interhospitalaria de Investigación Cardiovascular, Madrid, Spain. 5. Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain; Servicio de Medicina Preventiva, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain. 6. Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universidad Rovira Virgili, Tarragona, Spain. 7. Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain; Elola Consultores, Madrid, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: Health outcomes research is done from clinical registries or administrative databases. The aim of this work was to evaluate the concordance of the Minimum Basic Data Set (MBDS) with the DIOCLES (Descripción de la Cardiopatía Isquémica en el Territorio Español) registry and to analyze the implications of use of the MBDS in the study of acute coronary syndrome in Spain. METHODS: Through indirect identifiers, DIOCLES was linked with MBDS and unique matches were selected. Some of most relevant variables for risk adjustment of in-hospital mortality due to acute myocardial infarction were considered. Kappa coefficient was used to evaluate the concordance; sensitivity, specificity and positive and negative predictive values to measure the validity of the MBDS, and the area under ROC (receiver operating characteristic) curve to calculate its discrimination. The results were compared among hospitals quintiles according to their contribution to DIOCLES. The influence of unmatched episodes on results was assessed by a sensitivity analysis, using looser linking criteria. RESULTS: Overall, 1539 (60.85%) unique matches were achieved. The prevalence was higher in DIOCLES (acute myocardial infarction: 71.09%; Killip 3-4: 9.17%; cerebrovascular accident: 0.97%; thrombolysis: 8.64%; angioplasty: 61.92% and coronary bypass: 1.75%) than in the MBDS (P < .001). The agreement level observed was almost perfect (κ = 0.863). The MBDS showed a sensitivity of 85.10% and a specificity of 98.31%. Most results were confirmed by using sensitivity analysis (79.95% episodes matched). CONCLUSIONS: The MBDS can be a useful tool for outcomes research of acute coronary syndrome in Spain. The contrast of DIOCLES and MBDS with medical records could verify their validity.
INTRODUCTION AND OBJECTIVES: Health outcomes research is done from clinical registries or administrative databases. The aim of this work was to evaluate the concordance of the Minimum Basic Data Set (MBDS) with the DIOCLES (Descripción de la Cardiopatía Isquémica en el Territorio Español) registry and to analyze the implications of use of the MBDS in the study of acute coronary syndrome in Spain. METHODS: Through indirect identifiers, DIOCLES was linked with MBDS and unique matches were selected. Some of most relevant variables for risk adjustment of in-hospital mortality due to acute myocardial infarction were considered. Kappa coefficient was used to evaluate the concordance; sensitivity, specificity and positive and negative predictive values to measure the validity of the MBDS, and the area under ROC (receiver operating characteristic) curve to calculate its discrimination. The results were compared among hospitals quintiles according to their contribution to DIOCLES. The influence of unmatched episodes on results was assessed by a sensitivity analysis, using looser linking criteria. RESULTS: Overall, 1539 (60.85%) unique matches were achieved. The prevalence was higher in DIOCLES (acute myocardial infarction: 71.09%; Killip 3-4: 9.17%; cerebrovascular accident: 0.97%; thrombolysis: 8.64%; angioplasty: 61.92% and coronary bypass: 1.75%) than in the MBDS (P < .001). The agreement level observed was almost perfect (κ = 0.863). The MBDS showed a sensitivity of 85.10% and a specificity of 98.31%. Most results were confirmed by using sensitivity analysis (79.95% episodes matched). CONCLUSIONS: The MBDS can be a useful tool for outcomes research of acute coronary syndrome in Spain. The contrast of DIOCLES and MBDS with medical records could verify their validity.
Keywords:
Acute coronary syndrome; Administrative database; Bases de datos administrativas; Clinical registries; Data linkage; Investigación de resultados; Outcomes research; Registros clínicos; Síndrome coronario agudo; Vinculación de datos
Authors: Ana Lopez-de-Andres; Rodrigo Jimenez-Garcia; Valentin Hernández-Barrera; Jose M de Miguel-Yanes; Romana Albaladejo-Vicente; Rosa Villanueva-Orbaiz; David Carabantes-Alarcon; Jose J Zamorano-Leon; Marta Lopez-Herranz; Javier de Miguel-Diez Journal: Cardiovasc Diabetol Date: 2021-04-22 Impact factor: 9.951
Authors: Isabel Aguilar-Palacio; María José Rabanaque; Lina Maldonado; Armando Chaure; José María Abad-Díez; Montse León-Latre; José Antonio Casasnovas; Sara Malo Journal: Int J Environ Res Public Health Date: 2020-10-20 Impact factor: 3.390