Venous thromboembolism discharge diagnoses in the Danish National Patient Registry should be used with caution

Venous thromboembolism discharge diagnoses in the Danish National Patient Registry should be used with caution
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DOI:
10.1016/j.jclinepi.2009.03.018
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发表时间:
2010-02-01
影响因子:
7.2
通讯作者:
Johnsen, Soren Paaske
Johnsen, Soren Paaske
中科院分区:
医学2区
文献类型:
--
作者:
Severinsen, Marianne Tang;Kristensen, Soren Risom;Johnsen, Soren Paaske

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目的:我们验证丹麦国家患者登记处静脉血栓栓塞(VTE)的出院诊断。研究设计和设置:我们在1994年至2006年期间,在丹麦国家患者登记处的丹麦队列研究“饮食、癌症和健康”的参与者中,确定了所有首次静脉血栓栓塞出院诊断。检索医疗记录,并由一名作者使用标准方案验证静脉血栓栓塞诊断。静脉血栓栓塞(VTE)出院诊断的阳性预测值(positive predictive value, PPV)计算为注册表诊断与表中真实诊断相对应的注册表诊断占所有注册表诊断的百分比。结果:我们检索了1135名参与者中1100名(96.9%)登记有静脉血栓栓塞(VTE)出院诊断的医疗记录;确诊病例626例,疑似病例17例。在病房编码的诊断PPV为75.0%(95%可信区间:71.9,77.9)。急诊科的诊断无效。PPV因VTE类型(深静脉血栓形成和肺栓塞)、诊断类型(原发性或继发性)和性别而异。结论:从行政登记处获得的静脉血栓栓塞数据是一个有价值的信息来源,但在医学研究中应谨慎使用。(C) 2010爱思唯尔公司版权所有。
Objective: We validated discharge diagnoses of venous thromboembolism (VTE) in the Danish National Patient Registry.Study Design and Setting: We identified all first-time VTE discharge diagnoses in the Danish National Patient Registry among participants of the Danish cohort study "Diet, Cancer, and Health", in the period from 1994 to 2006. Medical records were retrieved and VTE diagnoses were verified by one of the authors using a standard protocol. The positive predictive value (PPV) of a discharge diagnosis of VTE was calculated as percent of registry diagnoses with the cot-responding true diagnosis in the chart among all registry diagnoses.Results: We retrieved medical records from 1,100 of 1,135 participants (96.9%) registered with a discharge diagnosis of VTE; 626 diagnoses were confirmed and 17 were considered probable. The PPV of diagnoses coded at wards was 75.0% (95% confidence interval: 71.9, 77.9). Diagnoses from emergency departments were not valid. The PPV varied by type of VTE (deep venous thrombosis and pulmonary embolism), type of diagnosis (primary or secondary), and sex.Conclusion: Data on VTE obtained from administrative registries are a valuable source of information but should be used with caution in medical research. (C) 2010 Elsevier Inc. All rights reserved.