Skip to main content
Top
Published in: Critical Care 2/2002

Open Access 01-04-2003 | Research

Training in data definitions improves quality of intensive care data

Authors: Daniëlle GT Arts, Rob J Bosman, Evert de Jonge, Johannes CA Joore, Nicolette F de Keizer

Published in: Critical Care | Issue 2/2002

Login to get access

Abstract

Background

Our aim was to assess the contribution of training in data definitions and data extraction guidelines to improving quality of data for use in intensive care scoring systems such as the Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS) II in the Dutch National Intensive Care Evaluation (NICE) registry.

Methods

Before and after attending a central training programme, a training group of 31 intensive care physicians from Dutch hospitals who were newly participating in the NICE registry extracted data from three sample patient records. The 5-hour training programme provided participants with guidelines for data extraction and strict data definitions. A control group of 10 intensive care physicians, who were trained according the to train-the-trainer principle at least 6 months before the study, extracted the data twice, without specific training in between.

Results

In the training group the mean percentage of accurate data increased significantly after training for all NICE variables (+7%, 95% confidence interval 5%–10%), for APACHE II variables (+6%, 95% confidence interval 4%–9%) and for SAPS II variables (+4%, 95% confidence interval 1%–6%). The percentage data error due to nonadherence to data definitions decreased by 3.5% after training. Deviations from 'gold standard' SAPS II scores and predicted mortalities decreased significantly after training. Data accuracy in the control group did not change between the two data extractions and was equal to post-training data accuracy in the training group.

Conclusion

Training in data definitions and data extraction guidelines is an effective way to improve quality of intensive care scoring data.
Literature
1.
go back to reference Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med 1985, 13: 818-829.CrossRefPubMed Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med 1985, 13: 818-829.CrossRefPubMed
2.
go back to reference Le Gall JR, Lemeshow S, Saulnier F: A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993, 270: 2957-2963. 10.1001/jama.270.24.2957CrossRefPubMed Le Gall JR, Lemeshow S, Saulnier F: A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993, 270: 2957-2963. 10.1001/jama.270.24.2957CrossRefPubMed
3.
go back to reference Fery-Lemonnier E, Landais P, Loirat P, Kleinknecht D, Brivet F: Evaluation of severity scoring systems in ICUs: translation, conversion and definition ambiguities as a source of interobserver variability in Apache II, SAPS and OSF. Intensive Care Med 1995, 21: 356-360.CrossRefPubMed Fery-Lemonnier E, Landais P, Loirat P, Kleinknecht D, Brivet F: Evaluation of severity scoring systems in ICUs: translation, conversion and definition ambiguities as a source of interobserver variability in Apache II, SAPS and OSF. Intensive Care Med 1995, 21: 356-360.CrossRefPubMed
4.
go back to reference Chen LM, Martin CM, Morrison TL, Sibbald WJ: Interobserver variability in data collection of the APACHE II score in teaching and community hospitals. Crit Care Med 1999, 27: 1999-2004. 10.1097/00003246-199909000-00046CrossRefPubMed Chen LM, Martin CM, Morrison TL, Sibbald WJ: Interobserver variability in data collection of the APACHE II score in teaching and community hospitals. Crit Care Med 1999, 27: 1999-2004. 10.1097/00003246-199909000-00046CrossRefPubMed
5.
go back to reference Holt AW, Bury LK, Bersten AD, Skowronski GA, Vedig AE: Prospective evaluation of residents and nurses as severity score data collectors. Crit Care Med 1992, 20: 1688-1691.CrossRefPubMed Holt AW, Bury LK, Bersten AD, Skowronski GA, Vedig AE: Prospective evaluation of residents and nurses as severity score data collectors. Crit Care Med 1992, 20: 1688-1691.CrossRefPubMed
6.
go back to reference Goldhill DR, Sumner A: APACHE II, data accuracy and outcome prediction. Anaesthesia 1998, 53: 937-943. 10.1046/j.1365-2044.1998.00534.xCrossRefPubMed Goldhill DR, Sumner A: APACHE II, data accuracy and outcome prediction. Anaesthesia 1998, 53: 937-943. 10.1046/j.1365-2044.1998.00534.xCrossRefPubMed
7.
go back to reference Damiano AM, Bergner M, Draper EA, Knaus WA, Wagner DP: Reliability of a measure of severity of illness: acute physiology of chronic health evaluation II. J Clin Epidemiol 1992, 45: 93-101.CrossRefPubMed Damiano AM, Bergner M, Draper EA, Knaus WA, Wagner DP: Reliability of a measure of severity of illness: acute physiology of chronic health evaluation II. J Clin Epidemiol 1992, 45: 93-101.CrossRefPubMed
8.
go back to reference Polderman KH, Thijs LG, Girbes AR: Interobserver variability in the use of APACHE II scores. Lancet 1999, 353: 380.CrossRefPubMed Polderman KH, Thijs LG, Girbes AR: Interobserver variability in the use of APACHE II scores. Lancet 1999, 353: 380.CrossRefPubMed
9.
go back to reference Polderman K, Christiaans H, Wester J, Spijkstra J, Girbes A: Intra-observer variability in APACHE II scoring. Intensive Care Med 2001, 27: 1550-1552. 10.1007/s001340101033CrossRefPubMed Polderman K, Christiaans H, Wester J, Spijkstra J, Girbes A: Intra-observer variability in APACHE II scoring. Intensive Care Med 2001, 27: 1550-1552. 10.1007/s001340101033CrossRefPubMed
10.
go back to reference Polderman K, Jorna E, Girbes A: Interobserver variability in APACHE II scoring: effect of strict guidelines and training. Intensive Care Med 2001, 27: 1365-1369. 10.1007/s001340101012CrossRefPubMed Polderman K, Jorna E, Girbes A: Interobserver variability in APACHE II scoring: effect of strict guidelines and training. Intensive Care Med 2001, 27: 1365-1369. 10.1007/s001340101012CrossRefPubMed
11.
go back to reference Arts DGT, de Keizer NF, Scheffer GJ: Defining and improving data quality in medical registries: a literature review, case study, and generic framework. J Am Med Inform Assoc 2002, 9: 600-611. 10.1197/jamia.M1087PubMedCentralCrossRefPubMed Arts DGT, de Keizer NF, Scheffer GJ: Defining and improving data quality in medical registries: a literature review, case study, and generic framework. J Am Med Inform Assoc 2002, 9: 600-611. 10.1197/jamia.M1087PubMedCentralCrossRefPubMed
13.
go back to reference Lemeshow S, Klar J, Teres D, Spitz Avrunin J, Gehlbach S, Rapoport J, Rué M: Mortality probability models for patients in the intensive care unit for 48 or 72 hours: a prospective, multicenter study. Crit Care Med 1994, 22: 1351-1358.CrossRefPubMed Lemeshow S, Klar J, Teres D, Spitz Avrunin J, Gehlbach S, Rapoport J, Rué M: Mortality probability models for patients in the intensive care unit for 48 or 72 hours: a prospective, multicenter study. Crit Care Med 1994, 22: 1351-1358.CrossRefPubMed
14.
go back to reference Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, Sirio CA, Murphy DJ, Lotring T, Damiano A: The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991, 100: 1619-1636.CrossRefPubMed Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, Sirio CA, Murphy DJ, Lotring T, Damiano A: The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991, 100: 1619-1636.CrossRefPubMed
15.
go back to reference Le Gall JR, Klar J, Lemeshow S, Saulnier F, Alberti C, Artigas A, Teres D: The Logistic Organ Dysfunction system. A new way to assess organ dysfunction in the intensive care unit. ICU Scoring Group. JAMA 1996, 276: 802-810. 10.1001/jama.276.10.802CrossRefPubMed Le Gall JR, Klar J, Lemeshow S, Saulnier F, Alberti C, Artigas A, Teres D: The Logistic Organ Dysfunction system. A new way to assess organ dysfunction in the intensive care unit. ICU Scoring Group. JAMA 1996, 276: 802-810. 10.1001/jama.276.10.802CrossRefPubMed
16.
go back to reference Arts D, de Keizer N, Scheffer G, de Jonge E: Quality of data collected for severity of illness scores in the Dutch National Intensive Care Evaluation (NICE) registry. Intensive Care Med 2002, 28: 656-659. 10.1007/s00134-002-1272-zCrossRefPubMed Arts D, de Keizer N, Scheffer G, de Jonge E: Quality of data collected for severity of illness scores in the Dutch National Intensive Care Evaluation (NICE) registry. Intensive Care Med 2002, 28: 656-659. 10.1007/s00134-002-1272-zCrossRefPubMed
Metadata
Title
Training in data definitions improves quality of intensive care data
Authors
Daniëlle GT Arts
Rob J Bosman
Evert de Jonge
Johannes CA Joore
Nicolette F de Keizer
Publication date
01-04-2003
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2002
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc1886

Other articles of this Issue 2/2002

Critical Care 2/2002 Go to the issue