Differential case ascertainment in clinical registry versus administrative data and impact on outcomes assessment for pediatric cardiac operations.

摘要: Background Administrative datasets are often used to assess outcomes and quality of pediatric cardiac programs; however their accuracy regarding case ascertainment is unclear. We linked patient data (2004–2010) from the Society Thoracic Surgeons Congenital Heart Surgery (STS-CHS) Database (clinical registry) Pediatric Health Information Systems (PHIS) database (administrative database) hospitals participating in both evaluate differential coding/classification operations between subsequent impact on assessment. Methods Eight individual benchmark Risk Adjustment Surgery, version 1 (RACHS-1) categories were evaluated. The primary outcome was in-hospital mortality. Results cohort included 59,820 patients 33 centers. There a greater than 10% difference number cases identified sources for half operations. negative predictive value (NPV) administrative (versus clinical) high (98.8%–99.9%); positive (PPV) lower (56.7%–88.0%). Overall agreement RACHS-1 category assignment 68.4%. These differences translated into significant assessment, ranging an underestimation mortality associated with truncus arteriosus repair by 25.7% versus clinical (7.01% 9.43%; p = 0.001) overestimation ventricular septal defect (VSD) 31.0% (0.78% 0.60%; 0.1). For categories, these ranged 5 40.5% 2 12.1%; not statistically significant. Conclusions This study demonstrates registry children undergoing operations, which important