CDARS data is not accurate enough for clinical audit on ...
Transcript of CDARS data is not accurate enough for clinical audit on ...
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
Evaluate the Quality of Medical Care
Structure
Process
Outcome
Avedis Donabedian
Common Outcome Measures in Clinical Audit
Mortality (30-day / In-hospital)
Survival (Overall / Symptom-free / Recurrence-free)
Length of StayMorbidity MobilityPatient Satisfaction
Outcomes are influenced by
DefinitionsData QualityPatient Case-mixQuality of CareChance
Data Quality is a Crucial Factor in defining the Quality
of whole audit project
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
The Accuracy and Completeness of CDARS had not been Verified
Accuracy of Morbidity Data in CDARS
Case Notes Review by investigators
CDARS
Patients
Elective Oesophagectomies for Squamous Cell Carcinoma of Oesophagus performed in all HA Hospitals (1/7/2001 to 31/7/2005)
Morbidity of Oesophagectomy
PneumoniaChylothoraxAnastomotic Leakage
Results
545 patients in 14 HA hospitals 227 out of 543 patients had at least one complication (41.8%)
Case Notes Review Vs CDARS
132
23
4726
924
Pneumonia Chylothorax Anastomotic Leakage
Case Notes Review CDARS
Pick-up rates
Case Note
ReviewCDARS
Pick-up rate
(CDARS)
Pneumonia 132 26 20%
Chylothorax 23 9 39%
Anastomotic Leakage 47 24 51%
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