Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)

Clinical and Administrative Data on the Research of Acute Coronary Syndrome in Spain. Minimum Basic Data Set Validity

José Luis Bernal a,b,, José A. Barrabés c, Andrés Íñiguez d, Antonio Fernández-Ortiz e,f, Cristina Fernández-Pérez b,g, Alfredo Bardají h, Francisco Javier Elola b,i

a Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
b Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain
c Servicio de Cardiología, Hospital Universitario Vall d’Hebron, Vall d’Hebron, Institut de Recerca (VHIR), CIBER-CV, Universidad Autónoma de Barcelona, Barcelona, Spain
d Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
e Servicio de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain
f Fundación Interhospitalaria de Investigación Cardiovascular, Madrid, Spain
g Servicio de Medicina Preventiva, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
h Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, Institut d’Investigació Sanitària Pere Virgili (IISPV), Universidad Rovira Virgili, Tarragona, Spain
i Elola Consultores, Madrid, Spain

Keywords

Acute coronary syndrome. Outcomes research. Clinical registries. Administrative database. Data linkage.

Abstract

Introduction and objectives

Health outcomes research is done from clinical registries or administrative databases. The aim of this work was to evaluate the concordance of the Minimum Basic Data Set (MBDS) with the DIOCLES (Descripción de la Cardiopatía Isquémica en el Territorio Español) registry and to analyze the implications of use of the MBDS in the study of acute coronary syndrome in Spain.

Methods

Through indirect identifiers, DIOCLES was linked with MBDS and unique matches were selected. Some of most relevant variables for risk adjustment of in-hospital mortality due to acute myocardial infarction were considered. Kappa coefficient was used to evaluate the concordance; sensitivity, specificity and positive and negative predictive values to measure the validity of the MBDS, and the area under ROC (receiver operating characteristic) curve to calculate its discrimination. The results were compared among hospitals quintiles according to their contribution to DIOCLES. The influence of unmatched episodes on results was assessed by a sensitivity analysis, using looser linking criteria.

Results

Overall, 1539 (60.85%) unique matches were achieved. The prevalence was higher in DIOCLES (acute myocardial infarction: 71.09%; Killip 3-4: 9.17%; cerebrovascular accident: 0.97%; thrombolysis: 8.64%; angioplasty: 61.92% and coronary bypass: 1.75%) than in the MBDS (P < .001). The agreement level observed was almost perfect (κ = 0.863). The MBDS showed a sensitivity of 85.10% and a specificity of 98.31%. Most results were confirmed by using sensitivity analysis (79.95% episodes matched).

Conclusions

The MBDS can be a useful tool for outcomes research of acute coronary syndrome in Spain. The contrast of DIOCLES and MBDS with medical records could verify their validity.

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1885-5857/© 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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