HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Syma L. Prince Mitchell J. Magee Michael J. Mack Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Herbert, M. A. Articles by Mack, M. J. Search for Related Content PubMed PubMed Citation Articles by Herbert, M. A. Articles by Mack, M. J. Related Collections Professional affairs

Ann Thorac Surg 2004;77:1960-1964
© 2004 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Are unaudited records from an outcomes registry database accurate?

^a Department of Research, Medical City Dallas Hospital, USA
^b Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA

Accepted for publication December 12, 2003.

^* Address reprint requests to Dr Herbert, Department of Research, Medical City Dallas Hospital, 7777 Forest Ln, Suite C-740, Dallas, TX 75230, USA
e-mail: morley.herbert{at}lonestarhealth.com

BACKGROUND: Data from outcomes registry databases are being increasingly used for peer review and public reporting. However, administrative and clinical databases are mostly unaudited; thus, their accuracy has not been verified.

METHODS: Outcomes data from all coronary artery bypass operations from a single cardiac surgery practice were entered into The Society of Thoracic Surgeons (STS) National Cardiac Database. From our practice of 18 surgeons, we audited 247 (10%) of the clinical records of patients undergoing surgery in 2001 and correlated them with all 315 elements of the STS National Cardiac Database for verification of accuracy. Inaccuracies were defined as a disagreement with a nominal or categorical variable or, for continuous variables, as the value not being within a predetermined window. When discrepancies existed, the hospital clinical record was assumed to be accurate. Outcomes discrepancies were then analyzed by four major categories: components of the preoperative risk algorithm, operative mortality, major complications, and other outcomes.

RESULTS: Discrepancies were noted in 5% (16) or fewer of the audited fields for 98.8% of the records. Of the 32 variables in the mortality risk algorithms, discrepancies were present in fewer than 10% of the audits on 30 of the 32 variables. More than 95% of the audited charts had zero or one discrepancy in the seven most important variables in the mortality risk models. Operative mortality was determined to be completely accurate with no discrepancies between the database and the audited clinical record. Among major complications, the error rate was less than 1% for all complications except prolonged ventilation (4.0%). A higher rate of discrepancies did exist in some of the other variables, including discharge medications (14.1%) and ventilator time (36.4%).

CONCLUSIONS: A detailed audit of a clinical outcomes registry database demonstrated that the major fields within this specific database including operative mortality, major complications, and the significant factors in the risk algorithm were highly accurate. Process improvement factors were identified to further increase the accuracy of data collection.

This article has been cited by other articles:

				S. M. O'Brien, E. R. DeLong, R. S. Dokholyan, F. H. Edwards, and E. D. Peterson Exploring the Behavior of Hospital Composite Performance Measures: An Example From Coronary Artery Bypass Surgery Circulation, December 18, 2007; 116(25): 2969 - 2975. [Abstract] [Full Text] [PDF]

				K. F. Welke, E. D. Peterson, M. S. Vaughan-Sarrazin, S. M. O'Brien, G. E. Rosenthal, G. J. Shook, R. S. Dokholyan, C. K. Haan, and T. B. Ferguson Jr Comparison of Cardiac Surgery Volumes and Mortality Rates Between The Society of Thoracic Surgeons and Medicare Databases From 1993 Through 2001 Ann. Thorac. Surg., November 1, 2007; 84(5): 1538 - 1546. [Abstract] [Full Text] [PDF]

				M. J. Magee, M. A. Herbert, T. M. Dewey, J. R. Edgerton, W. H. Ryan, S. Prince, and M. J. Mack Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery: Development of a Predictive Risk Algorithm Ann. Thorac. Surg., May 1, 2007; 83(5): 1707 - 1712. [Abstract] [Full Text] [PDF]

				P. E. Falcoz, M. Conti, L. Brouchet, S. Chocron, M. Puyraveau, M. Mercier, J. P. Etievent, and M. Dahan The Thoracic Surgery Scoring System (Thoracoscore): Risk model for in-hospital death in 15,183 patients requiring thoracic surgery J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 325 - 332. [Abstract] [Full Text] [PDF]

				R. J.F. Baskett, F. H. Cafferty, S. J. Powell, R. Kinsman, B. E. Keogh, and S. A.M. Nashef Total Arterial Revascularization is Safe: Multicenter Ten-Year Analysis of 71,470 Coronary Procedures Ann. Thorac. Surg., April 1, 2006; 81(4): 1243 - 1248. [Abstract] [Full Text] [PDF]

				M. J. Mack, M. Herbert, S. Prince, T. M. Dewey, M. J. Magee, and J. R. Edgerton Does reporting of coronary artery bypass grafting from administrative databases accurately reflect actual clinical outcomes? J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1309 - 1317. [Abstract] [Full Text] [PDF]

				R. H. Jones The Year in Cardiovascular Surgery J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1517 - 1528. [Full Text] [PDF]