Data errors in the National Hip Fracture Database

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Abstract

We present an audit comparing our level I major trauma centre's data for a cohort of patients with hip fractures in the National Hip Fracture Database (NHFD) with locally held data on these patients.

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The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

Jenny Neuburger, Colin Currie, Robert Wakeman … (2015)

Background: Hip fracture is the most common serious injury of older people. The UK National Hip Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve the quality of hip fracture care, but has not yet been externally evaluated. Methods: We used routinely collected data on 471,590 older people (aged 60 years and older) admitted with a hip fracture to National Health Service (NHS) hospitals in England between 2003 and 2011. The main variables of interest were the use of early surgery (on day of admission, or day after) and mortality at 30 days from admission. We compared time trends in the periods 2003–2007 and 2007–2011 (before and after the launch of the NHFD), using Poisson regression models to adjust for demographic changes. Findings: The number of hospitals participating in the NHFD increased from 11 in 2007 to 175 in 2011. From 2007 to 2011, the rate of early surgery increased from 54.5% to 71.3%, whereas the rate had remained stable over the period 2003–2007. Thirty-day mortality fell from 10.9% to 8.5%, compared with a small reduction from 11.5% to 10.9% previously. The annual relative reduction in adjusted 30-day mortality was 1.8% per year in the period 2003–2007, compared with 7.6% per year over 2007–2011 (P<0.001 for the difference). Interpretation: The launch of a national clinician-led audit initiative was associated with substantial improvements in care and survival of older people with hip fracture in England.

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Administrative database research has unique characteristics that can risk biased results.

Carl van Walraven, Peter S. Austin (2012)

The provision of health care frequently creates digitized data--such as physician service claims, medication prescription records, and hospitalization abstracts--that can be used to conduct studies termed "administrative database research." While most guidelines for assessing the validity of observational studies apply to administrative database research, the unique data source and analytical opportunities for these studies create risks that can make them uninterpretable or bias their results. Nonsystematic review. The risks of uninterpretable or biased results can be minimized by; providing a robust description of the data tables used, focusing on both why and how they were created; measuring and reporting the accuracy of diagnostic and procedural codes used; distinguishing between clinical significance and statistical significance; properly accounting for any time-dependent nature of variables; and analyzing clustered data properly to explore its influence on study outcomes. This article reviewed these five issues as they pertain to administrative database research to help maximize the utility of these studies for both readers and writers. Copyright © 2012 Elsevier Inc. All rights reserved.

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Patient registries: utility, validity and inference.

Kendra Vehik, Rachel Lynn Richesson (2009)

Patient registries are essential tools for public health surveillance and research inquiry, and are a particularly important resource for understanding rare diseases. Registries provide consistent data for defined populations and can support the study of the distribution and determinants of various diseases. One advantage of registries is the ability to observe caseload and population characteristics over time, which might facilitate the evaluation of disease incidence, disease etiology, planning, operation and evaluation of services, evaluation of treatment patterns, and diagnostic classification. Any registry program must collect high quality data to be useful for its stated purpose. Registries can be developed for many different needs, and caution should be taken in interpreting registry data, which has inherent biases. We describe the methodological issues, limitations, and ideal features of registries to support various rare disease purposes. The future impact of registries on our understanding and interventions for rare diseases will depend upon technological and political solutions for global cooperation to achieve consistent data (via standards) and regulations for various registry applications.

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Author and article information

Journal

Title: The Bone & Joint Journal

Abbreviated Title: The Bone & Joint Journal

Publisher: British Editorial Society of Bone & Joint Surgery

ISSN (Print): 2049-4394

ISSN (Electronic): 2049-4408

Publication date Created: October 2016

Publication date (Print): October 2016

Volume: 98-B

Issue: 10

Pages: 1406-1409

Affiliations

[1 ]Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

[2 ]School of Clinical Medicine, Cambridge University Hospitals NHS Foundation Trust, UK.

Article

DOI: 10.1302/0301-620X.98B10.37089

PubMed ID: 27694597

SO-VID: b4bb02f3-2754-4901-b473-4c16b6198a40

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Data errors in the National Hip Fracture Database : a local validation study

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Abstract

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Fracture and Structural Integrity

Most cited references 15

The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

Administrative database research has unique characteristics that can risk biased results.

Patient registries: utility, validity and inference.

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