Adherence to Methodological Standards in Research Using the National Inpatient Sample.
Adherence to Methodological Standards in Research Using the National Inpatient Sample.
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DOI：
10.1001/jama.2017.17653
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发表时间：
2017-11-28
期刊：
影响因子：
--
通讯作者：
Krumholz HM
中科院分区：
文献类型：
--
作者：
Khera R;Angraal S;Couch T;Welsh JW;Nallamothu BK;Girotra S;Chan PS;Krumholz HM
公开可用的数据集具有很大的潜力，但其独特的设计可能需要特定的分析方法。为了确定对经常使用的大型公共数据库的适当研究实践的遵守情况，医疗保健研究和质量机构（AHRQ）的国家住院患者样本（NIS）。在这项观察性研究中，在2015年1月至2016年12月期间使用NIS发表的1082项研究中，对120项研究的代表性样本进行了系统性评价，以确保遵守AHRQ要求的使用NIS设计和进行研究的实践。所有研究都是根据AHRQ的建议在7个必要的研究实践中进行评估的，这些研究实践分为3个领域：（将数据解释为住院记录，而不是独特的患者）;（B）研究设计（在不适当的情况下，避免用于执行州、医院和医生级别的评估;不使用非特异性管理二级诊断代码来研究院内事件），和（C）数据分析（解释NIS的复杂调查设计和数据结构随时间的变化）。在120项已发表的研究中，85%（n=102）未遵守≥1项要求的实践，62%（n=74）未遵守≥2项要求的实践。估计分别有925篇（95% CI 852-998）和696篇（95% CI 596-796）NIS出版物违反了≥1项和≥2项要求的实践。抽样研究共79项，占68.3%。（95%CI 59.3-77.3），未考虑抽样误差、聚类和分层的影响; 62（54.4%，95% CI 44.7-64.0）外推非特异性次要诊断以推断院内事件; 45（40.4%，95% CI 30.9-50.0）将住院误分类为个体患者; 10（7.1%，95% CI 2.1-12.1）进行了州水平分析; 3例（2.9%，95% CI 0.0-6.2）报告了医生水平的容量估计值。在27项研究（加权：218项研究，95% CI 134-303）中，21项（79.7%，95% CI 62.5-97.0）没有解释NIS数据结构的重大变化。在影响因子≥10的期刊上发表的24项研究中，分别有16项（67%）和9项（38%）未遵守≥1项和≥2项实践。在这项使用NIS数据的120篇近期出版物的研究中，大多数没有遵守要求的做法。需要进一步研究，以确定提高使用国家创新系统的研究质量的战略，并评估使用其他公开数据集是否存在类似问题。
Publicly available datasets hold much potential, but their unique design may require specific analytic approaches. To determine adherence to appropriate research practices for a frequently used large public database, the National Inpatient Sample (NIS) of the Agency for Healthcare Research and Quality (AHRQ). In this observational study, of the 1082 studies published using the NIS from January 2015 – December 2016, a representative sample of 120 studies was systematically evaluated for adherence to practices required by AHRQ for design and conduct of research using the NIS. None All studies were evaluated on 7 required research practices based on AHRQ’s recommendations, compiled under 3 domains: (A) data interpretation (interpreting data as hospitalization records rather than unique patients); (B) research design (avoiding use in performing state-, hospital-, and physician-level assessments where inappropriate; not using non-specific administrative secondary diagnosis codes to study in-hospital events), and (C) data analysis (accounting for complex survey design of the NIS and changes in data structure over time). Of 120 published studies, 85% (n=102) did not adhere to ≥1 required practices and 62% (n=74) did not adhere to ≥2 required practices. An estimated 925 (95% CI 852–998) and 696 (95% CI 596–796) NIS publications had violations of ≥1 and ≥2 required practices, respectively. A total of 79 sampled studies, representing 68.3% (95% CI 59.3–77.3) of the 1082 NIS studies, did not account for the effects of sampling error, clustering, and stratification; 62 (54.4%, 95% CI 44.7–64.0) extrapolated non-specific secondary diagnoses to infer in-hospital events; 45 (40.4%, 95% CI 30.9–50.0) miscategorized hospitalizations as individual patients; 10 (7.1%, 95% CI 2.1–12.1) performed state-level analyses; and 3 (2.9%, 95% CI 0.0–6.2) reported physician-level volume estimates. Of 27 studies (weighted: 218 studies, 95% CI 134–303) spanning periods of major changes in the data structure of the NIS, 21 (79.7%, 95% CI 62.5–97.0) did not account for the changes. Among the 24 studies published in journals with an impact factor ≥10, 16 (67%) and 9 (38%) did not adhere to ≥1 and ≥2 practices, respectively. In this study of 120 recent publications that used data from the NIS, the majority did not adhere to required practices. Further research is needed to identify strategies to improve the quality of research using the NIS and assess whether there are similar problems with use of other publicly available data sets.
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
DOI：
10.1161/circoutcomes.117.003846
发表时间：
2017-07
期刊：
Circulation. Cardiovascular quality and outcomes
影响因子：
--
作者：
Khera R;Krumholz HM
通讯作者：
Krumholz HM
影响因子：
4.5
作者：
Motheral, B;Brooks, J;Stang, P
通讯作者：
Stang, P