Comparison of the Victorian Emergency Minimum Dataset to medical records for emergency presentations for acute cardiovascular conditions and unspecified chest pain

Abstract

Objective The Victorian Emergency Minimum Dataset (VEMD) collects administrative and clinical data for all presentations to Victorian public ED. The present study aimed to examine the level of agreement between the VEMD data and the medical record for a sample of patients coded as having acute cardiovascular conditions (acute coronary syndrome, stroke and transient ischaemic attack [TIA]) and unspecified chest pain in the VEMD. Methods Six months of data provided to the VEMD from a large metropolitan hospital was obtained, and a random sample of 10% of cases (n = 310) were selected for review. Data for eight VEMD items were compared for concordance to data recorded in the ED medical record. Results Complete concordance between the VEMD and medical records for all eight items was observed only for 101 (33%) presentations. Overall, the least concordant variables were those with a high number of coding options: usual type of accommodation (76%), referral pattern (84%) and primary diagnosis (85%). The concordance of the VEMD primary diagnosis varied when examined as individual codes (range 75%–100%) and when combined (acute coronary syndrome = 94%, stroke or TIA = 85% and chest pain unspecified = 75%). The level of agreement for some items improved when VEMD codings were combined. Conclusion When compared to the medical record, our data suggest there is likely variation in the accuracy of some VEMD items, and suggests a larger prospective validation of the VEMD is warranted. For researchers using existing VEMD data, combining of some codes may be necessary.

Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome

“…http://openheart.bmj.com/ Open Heart: first published as 10.1136/openhrt-2021-001792 on 18 October 2021. Downloaded fromCoronary artery disease accuracy in the data used in this study, particularly demographics, ACS diagnosis and EMS use 13. CONCLUSION Our findings suggest the NHFA's Warning Signs Campaign was associated with an increase in ACS ED presentations and EMS use, and a decrease in ED presentations via GPs.…”

“…However, a validation study that we conducted in one centre showed high accuracy in the data used in this study, particularly demographics, ACS diagnosis and EMS use. 13 …”

“…Validations of VEMD ACS data at one hospital showed high accuracy for key variables and diagnosis. 13 …”

“…Validations of VEMD ACS data at one hospital showed high accuracy for key variables and diagnosis. 13 National Heart Foundation's Warning Sign Campaign The NHFA intermittently ran a paid mass media Warning Signs Campaign in Victoria between 2009 and 2013 to increase awareness of ACS symptoms among residents and to encourage them to call EMS on experiencing these symptoms. Media included two television advertisements, radio and print.…”

Association of Socioeconomic Status With Outcomes and Care Quality in Patients Presenting With Undifferentiated Chest Pain in the Setting of Universal Health Care Coverage

“…Recent audit data of the VEMD data set identified a concordance rate with emergency department (ED) medical records of 100% for index myocardial infarction diagnosis and 94% for index ACS diagnosis. 17 Consecutive patients attended by EMS for chest pain were included in the study if paramedics recorded either of the following criteria on the patient care record: (1) pain in the chest or central chest or (2) a final or secondary EMS diagnosis of ischemic chest pain, ACS, acute myocardial infarction, pleuritic pain, or angina. Exclusion criteria included traumatic chest pain, ST‐segment–elevation myocardial infarction (either prehospital or hospital discharge diagnosis), interhospital transfers, patient refusal to be transported to a hospital, death before EMS transport to a hospital, and age <18 years.…”