Postoperative Myocardial Infarction in Administrative Data vs Clinical Registry: A Multi-Institutional Study

David A. Etzioni, Cynthia Lessow, Liliana G. Bordeianou, Hiroko Kunitake, Sarah E. Deery, Evie Carchman, Christina M. Papageorge, George Fuhrman, Rachel L. Seiler, James Ogilvie, Elizabeth B Habermann, Yu Hui H Chang, Samuel R. Money

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Abstract

Background: Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative MI. The goal of this study was to characterize discordance between administrative and registry data in the determination of postoperative myocardial infarction (MI). Study Design: This study was performed using data from the American College of Surgeons NSQIP merged with administrative data from 8 different hospitals, between 2013 and 2015. From each of these sources, the occurrence of a postoperative MI, as ascertained by administrative data and NSQIP data, were compared. In each situation in which the 2 sources disagreed (discordance), a 2-clinician chart review was performed to generate a "gold standard" determination as to the occurrence of postoperative MI. Results: A total of 43,289 operations met our inclusion criteria for analysis. Within this cohort a total of 230 cases of MI were identified by administrative data and/or NSQIP data (administrative rate 0.41%, NSQIP rate 0.42%). A total of 89 discordant ascertainments were identified, of which 42 were admin+/NSQIP- and 47 were admin-/NSQIP+. Accuracy (99.9% for both) and concordance (kappa = 0.89 [95% CI 0.86 to 0.92] for administrative data, kappa = 0.87 [95% CI 0.84 to 0.91] for NSQIP data) of the 2 systems were similar when compared against our gold standard (chart review). The majority of errors were related to false negatives, with sensitivity rates of 81% in both data sources. Conclusions: In this multi-institutional study, administrative data and NSQIP demonstrated a similar ability to determine the occurrence of postoperative MI. These findings do not demonstrate an advantage of registry data over administrative data in the determination of postoperative MI.

Original languageEnglish (US)
JournalJournal of the American College of Surgeons
DOIs
StateAccepted/In press - 2017

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Registries
Myocardial Infarction
Information Storage and Retrieval
Information Systems

ASJC Scopus subject areas

  • Surgery

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Postoperative Myocardial Infarction in Administrative Data vs Clinical Registry : A Multi-Institutional Study. / Etzioni, David A.; Lessow, Cynthia; Bordeianou, Liliana G.; Kunitake, Hiroko; Deery, Sarah E.; Carchman, Evie; Papageorge, Christina M.; Fuhrman, George; Seiler, Rachel L.; Ogilvie, James; Habermann, Elizabeth B; H Chang, Yu Hui; Money, Samuel R.

In: Journal of the American College of Surgeons, 2017.

Research output: Contribution to journalArticle

Etzioni, DA, Lessow, C, Bordeianou, LG, Kunitake, H, Deery, SE, Carchman, E, Papageorge, CM, Fuhrman, G, Seiler, RL, Ogilvie, J, Habermann, EB, H Chang, YH & Money, SR 2017, 'Postoperative Myocardial Infarction in Administrative Data vs Clinical Registry: A Multi-Institutional Study', Journal of the American College of Surgeons. https://doi.org/10.1016/j.jamcollsurg.2017.09.016
Etzioni, David A. ; Lessow, Cynthia ; Bordeianou, Liliana G. ; Kunitake, Hiroko ; Deery, Sarah E. ; Carchman, Evie ; Papageorge, Christina M. ; Fuhrman, George ; Seiler, Rachel L. ; Ogilvie, James ; Habermann, Elizabeth B ; H Chang, Yu Hui ; Money, Samuel R. / Postoperative Myocardial Infarction in Administrative Data vs Clinical Registry : A Multi-Institutional Study. In: Journal of the American College of Surgeons. 2017.
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abstract = "Background: Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative MI. The goal of this study was to characterize discordance between administrative and registry data in the determination of postoperative myocardial infarction (MI). Study Design: This study was performed using data from the American College of Surgeons NSQIP merged with administrative data from 8 different hospitals, between 2013 and 2015. From each of these sources, the occurrence of a postoperative MI, as ascertained by administrative data and NSQIP data, were compared. In each situation in which the 2 sources disagreed (discordance), a 2-clinician chart review was performed to generate a {"}gold standard{"} determination as to the occurrence of postoperative MI. Results: A total of 43,289 operations met our inclusion criteria for analysis. Within this cohort a total of 230 cases of MI were identified by administrative data and/or NSQIP data (administrative rate 0.41{\%}, NSQIP rate 0.42{\%}). A total of 89 discordant ascertainments were identified, of which 42 were admin+/NSQIP- and 47 were admin-/NSQIP+. Accuracy (99.9{\%} for both) and concordance (kappa = 0.89 [95{\%} CI 0.86 to 0.92] for administrative data, kappa = 0.87 [95{\%} CI 0.84 to 0.91] for NSQIP data) of the 2 systems were similar when compared against our gold standard (chart review). The majority of errors were related to false negatives, with sensitivity rates of 81{\%} in both data sources. Conclusions: In this multi-institutional study, administrative data and NSQIP demonstrated a similar ability to determine the occurrence of postoperative MI. These findings do not demonstrate an advantage of registry data over administrative data in the determination of postoperative MI.",
author = "Etzioni, {David A.} and Cynthia Lessow and Bordeianou, {Liliana G.} and Hiroko Kunitake and Deery, {Sarah E.} and Evie Carchman and Papageorge, {Christina M.} and George Fuhrman and Seiler, {Rachel L.} and James Ogilvie and Habermann, {Elizabeth B} and {H Chang}, {Yu Hui} and Money, {Samuel R.}",
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TY - JOUR

T1 - Postoperative Myocardial Infarction in Administrative Data vs Clinical Registry

T2 - A Multi-Institutional Study

AU - Etzioni, David A.

AU - Lessow, Cynthia

AU - Bordeianou, Liliana G.

AU - Kunitake, Hiroko

AU - Deery, Sarah E.

AU - Carchman, Evie

AU - Papageorge, Christina M.

AU - Fuhrman, George

AU - Seiler, Rachel L.

AU - Ogilvie, James

AU - Habermann, Elizabeth B

AU - H Chang, Yu Hui

AU - Money, Samuel R.

PY - 2017

Y1 - 2017

N2 - Background: Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative MI. The goal of this study was to characterize discordance between administrative and registry data in the determination of postoperative myocardial infarction (MI). Study Design: This study was performed using data from the American College of Surgeons NSQIP merged with administrative data from 8 different hospitals, between 2013 and 2015. From each of these sources, the occurrence of a postoperative MI, as ascertained by administrative data and NSQIP data, were compared. In each situation in which the 2 sources disagreed (discordance), a 2-clinician chart review was performed to generate a "gold standard" determination as to the occurrence of postoperative MI. Results: A total of 43,289 operations met our inclusion criteria for analysis. Within this cohort a total of 230 cases of MI were identified by administrative data and/or NSQIP data (administrative rate 0.41%, NSQIP rate 0.42%). A total of 89 discordant ascertainments were identified, of which 42 were admin+/NSQIP- and 47 were admin-/NSQIP+. Accuracy (99.9% for both) and concordance (kappa = 0.89 [95% CI 0.86 to 0.92] for administrative data, kappa = 0.87 [95% CI 0.84 to 0.91] for NSQIP data) of the 2 systems were similar when compared against our gold standard (chart review). The majority of errors were related to false negatives, with sensitivity rates of 81% in both data sources. Conclusions: In this multi-institutional study, administrative data and NSQIP demonstrated a similar ability to determine the occurrence of postoperative MI. These findings do not demonstrate an advantage of registry data over administrative data in the determination of postoperative MI.

AB - Background: Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative MI. The goal of this study was to characterize discordance between administrative and registry data in the determination of postoperative myocardial infarction (MI). Study Design: This study was performed using data from the American College of Surgeons NSQIP merged with administrative data from 8 different hospitals, between 2013 and 2015. From each of these sources, the occurrence of a postoperative MI, as ascertained by administrative data and NSQIP data, were compared. In each situation in which the 2 sources disagreed (discordance), a 2-clinician chart review was performed to generate a "gold standard" determination as to the occurrence of postoperative MI. Results: A total of 43,289 operations met our inclusion criteria for analysis. Within this cohort a total of 230 cases of MI were identified by administrative data and/or NSQIP data (administrative rate 0.41%, NSQIP rate 0.42%). A total of 89 discordant ascertainments were identified, of which 42 were admin+/NSQIP- and 47 were admin-/NSQIP+. Accuracy (99.9% for both) and concordance (kappa = 0.89 [95% CI 0.86 to 0.92] for administrative data, kappa = 0.87 [95% CI 0.84 to 0.91] for NSQIP data) of the 2 systems were similar when compared against our gold standard (chart review). The majority of errors were related to false negatives, with sensitivity rates of 81% in both data sources. Conclusions: In this multi-institutional study, administrative data and NSQIP demonstrated a similar ability to determine the occurrence of postoperative MI. These findings do not demonstrate an advantage of registry data over administrative data in the determination of postoperative MI.

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