Accuracy of obstetric diagnoses and procedures in hospital discharge data
Accuracy of obstetric diagnoses and procedures in hospital discharge data
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DOI：
10.1016/j.ajog.2005.08.058
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发表时间：
2006-04-01
影响因子：
9.8
通讯作者：
Gilbert, WM
中科院分区：
文献类型：
--
作者：
Yasmeen, S;Romano, PS;Gilbert, WM
目的：本研究的目的是评估加州患者出院数据中产科程序和诊断的有效性。研究设计：我们从 267 家加州医院中的 52 家中随机抽取了 1611 例分娩样本，这些医院在 1992 年至 1993 年间进行了超过 678 例合格分娩。我们将医院报告的程序和诊断与我们对相同记录的记录进行了比较。结果：剖腹产、产钳和真空吸宫术均得到准确报告，敏感性和阳性预测值超过90%。会阴切开术的报道不足（70% 敏感性）。据报告，剖宫产指征的敏感性至少为 60%。除了宫缩乏力、疱疹和产程过长之外。在合并症中，绒毛膜羊膜炎、糖尿病、早产、先兆子痫和宫内死亡的敏感性超过 60%。对贫血、哮喘、甲状腺疾病、精神疾病、药物滥用、泌尿生殖系统感染、肥胖、子宫肌瘤、胎儿生长过度、高血压、早产、羊水过多和过期妊娠的敏感性较差（低于 60%）。结论：医院报告的产科手术和诊断的有效性各不相同，某些代码的准确性为中等到高，但其他代码的准确性较差。 (C) 2006 Mosby, Inc. 保留所有权利。
Objective: The objective of the study was to estimate the validity of obstetric procedures and diagnoses in California patient discharge data.Study design: We randomly sampled 1611 deliveries from 52 of 267 California hospitals that performed more than 678 eligible deliveries in 1992 to 1993. We compared hospital-reported procedures and diagnoses against our recoding of the same records.Results: Cesarean, forceps, and vacuum delivery were accurately reported, with sensitivities and positive predictive values exceeding 90%. Episiotomy was Underreported (70% sensitivity). Cesarean indications were reported with at least 60% sensitivity.. except uterine inertia, herpes, and long labor. Among comorbidities, sensitivity exceeded 60% for chorioamnionitis, diabetes, premature labor, preeclampsia, and intrauterine death. Sensitivity was poor (less than 60%) for anemia, asthma, thyroid disorders, mental disorders, drug abuse, genitourinary infections, obesity, fibroids, excessive fetal growth, hypertension, premature rupture, polyhydramnios, and postdates.Conclusion: The validity of hospital-reported obstetric procedures and diagnoses varies, with moderate to high accuracy for some codes but poor accuracy for others. (C) 2006 Mosby, Inc. All rights reserved.