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Published byTyler Allison Modified over 9 years ago
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CDC Site Visit at Emory CHD Surveillance Cooperative Agreement Data Quality & Validation September 25, 2013 Wendy Book, MD
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Purposes of Quality Control Completeness Accuracy
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Data Quality & Validation Compare consistency of data for patients who appear in two or more data sources – Examples : CHOA and Sibley Heart Center, PCS EHC Data Warehouse and Emory CHFT db Compare predicted age/race distribution to actual Sampling (certain diagnostic groups vs. percentage of all)
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Validation Strategies Validation Source Case Source: Linked MACDP Medical Record Reviews Abstract records for up to 100 cases of specific Dx MACDP Use procedure codes to refine diagnoses
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Hierarchy of Confidence in Reporting 1.Adult Congenital Heart Disease Specialists & Pediatric Cardiologists 2.Adult Cardiologists 3.Other Providers 4.Billing Data
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Possible Solutions for Discrepancies in Diagnostic Codes Major codes, used multiple times = primary diagnosis (possible through db management) Algorithms for multiple diagnoses TOF (745.2), COA (747.0) more likely to be clean and accurate diagnosis Perhaps, focus sampling on common diagnoses that have a high likelihood of inconsistencies Grouping all single ventricles?
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Medical Record Abstraction Performed by trained abstractors Abstract certain diagnoses only? Re-abstraction of 10% with MD review Considerations for number & source of records targeted for review: Resources Ability to access records Concerns regarding accuracy of coding
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Validation Compare prevalence across data sources & across sites – Prevalence MA & GA, NY adult prevalence With MACDP – more similar to NY, value added to adult population Validation across sites – similar methodologies, both same population compare /contrast Develop a ‘correction factor’ for “out of care”
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Alive Status With MACDP? c c NO YES NO But Not in Clinic or Medicaid Remove from MACDP Survivors PRESUMED SURVIVORS With MACDP Alive Status Y/N? In Clinic or MCAID? In 5-county Residency ALIVE ? DEAD ? Access NexisLexis YES But Not in Clinic or Medicaid Access NexisLexis c c But Not in Residency With MACDP Better estimate prevalence Develop a ‘correction’ factor With MACDP Better estimate prevalence Develop a ‘correction’ factor
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