Browsing by Author "Leal, Jenine R."

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    Development of International Indicators for Assessing the Quality of ICD-coded Administrative Health Data
    (2020-12-22) Otero Varela, Lucia; Quan, Hude; Eastwood, Cathy A.; Walker, Robin L.; Leal, Jenine R.
    Introduction: Health data are generated at each patient encounter with the healthcare system worldwide, then collected and stored as administrative health data. As an example, inpatient data are coded in the hospital morbidity database using the International Classification of Diseases (ICD), which is a reference standard for reporting diseases and health conditions globally. The quality of ICD-coded data is affected by multiple factors, such as worldwide variations in ICD use and its meta-features across countries, which can hinder meaningful comparisons of morbidity data. Assessing data quality is therefore essential for the ultimate goal of improving it. Given the current lack of an international approach for, we aimed to develop a standardized method for assessing hospital morbidity data quality. Methods: First, we conducted an international online questionnaire to better understand the differences in coding practices and hospital data collection systems across countries. Second, through the combination of a comprehensive environmental scan and a Delphi consensus process, we developed a set of global data quality indicators (DQIs) for the hospital morbidity database. Results: The international questionnaire revealed variances in all aspects of ICD data collection features, including: the maximum number of coding fields allowed for diagnosis and interventions, the definition of main condition, as well as the data fields that are mandatory to capture in the hospital morbidity database. The Delphi exercise resulted in 24 DQIs, encompassing five dimensions of data quality (e.g., Relevance, Accuracy and reliability, Comparability and coherence, Timeliness, and Accessibility and clarity), and can be used to assess data quality using the same standard across countries and to highlight areas in need of improvement. Conclusion: Emphasis should be placed on standardizing ICD data collection systems and enhancing the quality of ICD-coded data. These findings could facilitate international comparisons of health data and data quality, and could serve as a guidance for policy- and decision-makers worldwide.
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    The distinct category of healthcare associated bloodstream infections
    (BioMed Central, 2012-04-09) Lenz, Ryan; Leal, Jenine R.; Church, Deirdre L.; Gregson, Daniel B.; Ross, Terry; Laupland, Kevin B.
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    The Validation of a Novel Surveillance System for Monitoring Bloodstream Infections in the Calgary Zone
    (2016-06-07) Leal, Jenine R.; Gregson, Daniel B.; Church, Deirdre L.; Henderson, Elizabeth A.; Ross, Terry; Laupland, Kevin B.
    Background. Electronic surveillance systems (ESSs) that utilize existing information in databases are more efficient than conventional infection surveillance methods. The objective was to assess an ESS for bloodstream infections (BSIs) in the Calgary Zone for its agreement with traditional medical record review. Methods. The ESS was developed by linking related data from regional laboratory and hospital administrative databases and using set definitions for excluding contaminants and duplicate isolates. Infections were classified as hospital-acquired (HA), healthcare-associated community-onset (HCA), or community-acquired (CA). A random sample of patients from the ESS was then compared with independent medical record review. Results. Among the 308 patients selected for comparative review, the ESS identified 318 episodes of BSI of which 130 (40.9%) were CA, 98 (30.8%) were HCA, and 90 (28.3%) were HA. Medical record review identified 313 episodes of which 136 (43.4%) were CA, 97 (30.9%) were HCA, and 80 (25.6%) were HA. Episodes of BSI were concordant in 304 (97%) cases. Overall, there was 85.5% agreement between ESS and medical record review for the classification of where BSIs were acquired (kappa = 0.78, 95% Confidence Interval: 0.75–0.80). Conclusion. This novel ESS identified and classified BSIs with a high degree of accuracy. This system requires additional linkages with other related databases.