A Validation Study of the Canadian Organ Replacement Register

Abstract

SummaryBackground and objectives Accurate and complete documentation of patient characteristics and comorbidities in renal registers is essential to control bias in the comparison of outcomes across groups of patients or dialysis facilities. The objectives of this study were to assess the quality of data collected in the Canadian Organ Replacement Register (CORR) compared with the patient's medical charts. Design, setting, participants, & measurementsThis cohort study of a representative sample of adult, incident patients registered in CORR in 2005 to 2006 examined the prevalence, sensitivity, specificity, positive and negative predictive values, and of comorbid conditions and agreement in coding of patient demographics and primary renal disease between CORR and the patient's medical record. The effect of coding variation on patient survival was evaluated.Results Medical records on 1125 patients were reviewed. Agreement exceeded 97% for health card number, date of birth, and sex and 71% (range 46.6 to 89.1%) for the primary renal disease. Comorbid conditions were under-reported in CORR. Sensitivities ranged from 0.89 (95% confidence interval 0.80, 0.92) for hypertension to 0.47 (0.38, 0.55) for peripheral vascular disease. Specificity was Ͼ0.93 for all comorbidities except hypertension. Hazard ratios for death were similar whether calculated using data from CORR or the medical record.Conclusions Comorbid conditions are under-reported in CORR; however, the associated risks of mortality were similar whether using the CORR data or the medical record data, suggesting that CORR data can be used in clinical research with minimal concern for bias.

Rehospitalizations and Emergency Department Visits after Hospital Discharge in Patients Receiving Maintenance Hemodialysis

“…However, the databases used in our studies are highly accurate and have been used in a number of studies. [33][34][35] Our findings have important implications. First, by highlighting the magnitude of the problem, we provide a rationale for further study on the determinants of rehospitalizations and the optimal role of the emergency department in the care of chronic hemodialysis recipients.…”

“…Prevalent patients were identified using the Canadian Organ Replacement Registry, which captures the incidence, prevalence, and dialysis treatment changes of .99% of patients receiving maintenance dialysis in Canada. 34 Information on all hospital admissions was obtained using the Canadian Institute for Health Information Discharge Abstract Database. This database contains the encrypted health card number, date of admission and discharge, and up to16 diagnoses in the International Classification of Diseases, Ninth Revision (before 2002), as well as 25 diagnoses in the International Classification of Diseases, 10th Revision (from 2002 onward).…”

Incidence and causes of end-stage renal disease among Aboriginal children and young adults

“…In a recent validation study comparing registry data with detailed clinical data from patient-level medical records, agreement between the two for primary renal disease was reported as 82.8% for glomerulonephritis and 78.3% for diabetes. 10 Lower agreement was noted for ethnicity (58%); however, discrepancies were frequently due to a specific race reported in the register, but reported as unknown in medical records.…”

Early Dialysis Initiation and Rates and Timing of Withdrawal From Dialysis in Canada

“…Normal BMI is defined as 18.5-24.9 kg/m 2 ; overweight, 25.0-29.9 kg/m 2 ; and obese, $30 kg/m 2 . A recent article by Moist et al (11) has validated the accuracy of the CORR comorbidity data.…”