期刊
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
卷 28, 期 3, 页码 578-587出版社
OXFORD UNIV PRESS
DOI: 10.1093/jamia/ocaa225
关键词
data quality; data validation; clinical databases; data extraction; electronic medical records
类别
资金
- Green Shield Canada Foundation
- University of Toronto Division of General Internal Medicine
- Mak Pak Chiu and Mak-Soo Lai Hing Chair in General Internal Medicine, University of Toronto
The study describes an approach to assess data quality in large clinical databases, using both computational checks and manual validation. The combination of these methods proved to be effective in ensuring high overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value in the data analyzed.
Objective: Large clinical databases are increasingly used for research and quality improvement. We describe an approach to data quality assessment from the General Medicine Inpatient Initiative (GEMINI), which collects and standardizes administrative and clinical data from hospitals. Methods: The GEMINI database contained 245 559 patient admissions at 7 hospitals in Ontario, Canada from 2010 to 2017. We performed 7 computational data quality checks and iteratively re-extracted data from hospitals to correct problems. Thereafter, GEMINI data were compared to data that were manually abstracted from the hospital's electronic medical record for 23 419 selected data points on a sample of 7488 patients. Results: Computational checks flagged 103 potential data quality issues, which were either corrected or documented to inform future analysis. For example, we identified the inclusion of canceled radiology tests, a time shift of transfusion data, and mistakenly processing the chemical symbol for sodium (Na) as a missing value. Manual validation identified 1 important data quality issue that was not detected by computational checks: transfusion dates and times at 1 site were unreliable. Apart from that single issue, across all data tables, GEMINI data had high overall accuracy (ranging from 98%-100%), sensitivity (95%-100%), specificity (99%-100%), positive predictive value (93%-100%), and negative predictive value (99%-100%) compared to the gold standard. Discussion and Conclusion: Computational data quality checks with iterative re-extraction facilitated reliable data collection from hospitals but missed 1 critical quality issue. Combining computational and manual approaches may be optimal for assessing the quality of large multisite clinical databases.
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