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Data quality predicts care quality: findings from a national clinical audit.
Yates, Mark; Bechman, Katie; Dennison, Elaine M; MacGregor, Alexander J; Ledingham, Jo; Norton, Sam; Galloway, James B.
Afiliación
  • Yates M; The Centre for Rheumatic Diseases, School of Immunology, Infection & Inflammatory Disease, King's College London, Room 3.46 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK. mark.yates@kcl.ac.uk.
  • Bechman K; The Centre for Rheumatic Diseases, School of Immunology, Infection & Inflammatory Disease, King's College London, Room 3.46 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK.
  • Dennison EM; MRC Epidemiology Unit, University of Southampton, Southampton, UK.
  • MacGregor AJ; Norwich Medical School, University of East Anglia, Norwich, UK.
  • Ledingham J; Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, UK.
  • Norton S; Institute of Psychiatry, Kings College London, London, UK.
  • Galloway JB; The Centre for Rheumatic Diseases, School of Immunology, Infection & Inflammatory Disease, King's College London, Room 3.46 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK.
Arthritis Res Ther ; 22(1): 87, 2020 04 17.
Article en En | MEDLINE | ID: mdl-32303251
BACKGROUND: Missing clinical outcome data are a common occurrence in longitudinal studies. Data quality in clinical audit is a particular cause for concern. The relationship between departmental levels of missing clinical outcome data and care quality is not known. We hypothesise that completeness of key outcome data in a national audit predicts departmental performance. METHODS: The National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis (NCAREIA) collected data on care of patients with suspected rheumatoid arthritis (RA) from early 2014 to late 2015. This observational cohort study collected data on patient demographics, departmental variables, service quality measures including time to treatment, and the key RA clinical outcome measure, disease activity at baseline, and 3 months follow-up. A mixed effects model was conducted to identify departments with high/low proportions of missing baseline disease activity data with the results plotted on a caterpillar graph. A mixed effects model was conducted to assess if missing baseline disease activity predicted prompt treatment. RESULTS: Six thousand two hundred five patients with complete treatment time data and a diagnosis of RA were recruited from 136 departments. 34.3% had missing disease activity at baseline. Mixed effects modelling identified 13 departments with high levels of missing disease activity, with a cluster observed in the Northwest of England. Missing baseline disease activity was associated with not commencing treatment promptly in an adjusted mix effects model, odds ratio 0.50 (95% CI 0.41 to 0.61, p < 0.0001). CONCLUSIONS: We have shown that poor engagement in a national audit program correlates with the quality of care provided. Our findings support the use of data completeness as an additional service quality indicator.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Calidad de la Atención de Salud / Exactitud de los Datos / Auditoría Médica Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Arthritis Res Ther Asunto de la revista: REUMATOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Calidad de la Atención de Salud / Exactitud de los Datos / Auditoría Médica Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Arthritis Res Ther Asunto de la revista: REUMATOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido