CDARS data is not accurate enough for clinical audit on ...
Transcript of CDARS data is not accurate enough for clinical audit on ...
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Clinical Data Analysis and Reporting System (CDARS) Data is Not
Accurate Enough for Clinical Audit on Postoperative Complications
A study on the accuracy of CDARS
TL Kwan, A Wai, WC YuenCentral Surgical Audit Unit,
Hospital Authority, Hong Kong
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Evaluate the Quality of Medical Care
Structure
Process
Outcome
Avedis Donabedian
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Common Outcome Measures in Clinical Audit
Mortality (30-day / In-hospital)
Survival (Overall / Symptom-free / Recurrence-free)
Length of StayMorbidity MobilityPatient Satisfaction
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Outcomes are influenced by
DefinitionsData QualityPatient Case-mixQuality of CareChance
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Data Quality is a Crucial Factor in defining the Quality
of whole audit project
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Overview of CDARS
CDARS CMS /IE5+
DataWarehouse
CMS
IPAS
OPAS
Dx, Px, Specialist I/C, MO I/C, OTRS
Radiology Examination
Patient DemographicsEpisode Movements
PHS/CDDH
LIS
RIS
Lab test with standardized units
Appointments & AttendancesInformation
AEIS
Drug Dispensed
Attendances Information
OBCIS Obstetric Information
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The Accuracy and Completeness of CDARS had not been Verified
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Accuracy of Morbidity Data in CDARS
Case Notes Review by investigators
CDARS
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Patients
Elective Oesophagectomies for Squamous Cell Carcinoma of Oesophagus performed in all HA Hospitals (1/7/2001 to 31/7/2005)
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Morbidity of Oesophagectomy
PneumoniaChylothoraxAnastomotic Leakage
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Results
545 patients in 14 HA hospitals 227 out of 543 patients had at least one complication (41.8%)
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Case Notes Review Vs CDARS
132
23
4726
924
Pneumonia Chylothorax Anastomotic Leakage
Case Notes Review CDARS
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Pick-up rates
Case Note
ReviewCDARS
Pick-up rate
(CDARS)
Pneumonia 132 26 20%
Chylothorax 23 9 39%
Anastomotic Leakage 47 24 51%
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Conclusion
Pick-up rates of common postoperative complications by CDARS were lowImportance of data verificationUnless the reporting mechanism of complications can be improved, extraction of complications data directlyfrom CDARS will not be useful