National surveillance of stroke quality of care and outcomes by applying post-stratification survey weights on the Get With The Guidelines-Stroke patient registry.
National surveillance of stroke quality of care and outcomes by applying post-stratification survey weights on the Get With The Guidelines-Stroke patient registry.
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通过应用指南-卒中患者登记处的分层后调查权重对卒中护理质量和结局进行国家监测。
DOI：
10.1186/s12874-021-01214-z
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发表时间：
2021-02-04
影响因子：
4
通讯作者：
Fonarow GC
中科院分区：
文献类型：
--
作者：
Ziaeian B;Xu H;Matsouaka RA;Xian Y;Khan Y;Schwamm LS;Smith EE;Fonarow GC
美国缺乏中风监测系统。本研究开发了一种方法，将现有的注册表转换为具有全国代表性的数据库，以评估急性缺血性卒中的护理质量。两种统计方法被用于通过将人群估计值锚定到国家住院患者样本来为遵循指南-卒中登记研究制定分层后权重。分层后的调查权重估计使用耙程序和贝叶斯插值方法。调整加权方法以限制权重的分散，并对患者特征、医院护理质量和临床结局进行合理的流行病学估计。报告了锚定和非锚定患者特征的两种后分层方法之间的国家估计值的标准化差异，以评估估计质量。评价的主要指标是患者和医院特征、卒中严重程度、生命体征和实验室指标、处置和出院时的临床结局。2012年至2014年期间，共发生了1，388，296例急性缺血性卒中。管理数据中不可用的临床数据的耙式和贝叶斯估计值估计在预期值界值的5 - 10%范围内。耙法的中位重量为1.386，第99百分位数的重量为6.881，最大重量为30.775。贝叶斯权重中位数为1.329，第99百分位数权重为11.201，最大权重为515.689。利用现有的数据库和患者登记来制定分层后权重是评估急性缺血性卒中流行病学和监测全国卒中护理质量的可靠方法。这些方法可以应用于其他疾病或环境，以更好地监测人口健康。在线版本包含补充材料，可通过10.1186/s12874-021-01214-z获得。
The U.S. lacks a stroke surveillance system. This study develops a method to transform an existing registry into a nationally representative database to evaluate acute ischemic stroke care quality. Two statistical approaches are used to develop post-stratification weights for the Get With The Guidelines-Stroke registry by anchoring population estimates to the National Inpatient Sample. Post-stratification survey weights are estimated using a raking procedure and Bayesian interpolation methods. Weighting methods are adjusted to limit the dispersion of weights and make reasonable epidemiologic estimates of patient characteristics, quality of hospital care, and clinical outcomes. Standardized differences in national estimates are reported between the two post-stratification methods for anchored and non-anchored patient characteristics to evaluate estimation quality. Primary measures evaluated are patient and hospital characteristics, stroke severity, vital and laboratory measures, disposition, and clinical outcomes at discharge. A total of 1,388,296 acute ischemic strokes occurred between 2012 and 2014. Raking and Bayesian estimates of clinical data not available in administrative data are estimated within 5 to 10% of margin for expected values. Median weight for the raking method is 1.386 and the weights at the 99th percentile is 6.881 with a maximum weight of 30.775. Median Bayesian weight is 1.329 and the 99th percentile weights is 11.201 with a maximum weight of 515.689. Leveraging existing databases with patient registries to develop post-stratification weights is a reliable approach to estimate acute ischemic stroke epidemiology and monitoring for stroke quality of care nationally. These methods may be applied to other diseases or settings to better monitor population health. The online version contains supplementary material available at 10.1186/s12874-021-01214-z.
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影响因子：
8.3
作者：
Soliman, Elsayed Z.;Howard, George;Howard, Virginia J.
通讯作者：
Howard, Virginia J.
影响因子：
5.4
作者：
Caughey, Devin;Wang, Mallory
通讯作者：
Wang, Mallory
影响因子：
5.4
作者：
Chang TE;Lichtman JH;Goldstein LB;George MG
通讯作者：
George MG
DOI：
10.2307/2344652
发表时间：
1979-01-01
影响因子：
2
作者：
HOLT, D;SMITH, TMF
通讯作者：
SMITH, TMF
影响因子：
8.3
作者：
Reeves, Mathew J.;Fonarow, Gregg C.;Schwamm, Lee H.
通讯作者：
Schwamm, Lee H.