Data Quality Improvement and Internal Data Audit of the Chinese Neonatal Network Data Collection System

Sun, Jianhua; Cao, Yun; Hei, Mingyan; Sun, Huiqing; Wang, Laishuan; Zhou, Wei; Chen, Xiafang; Jiang, Siyuan; Zhang, Huayan; Ma, Xiaolu; Wu, Hui; Li, Xiaoying; Shi, Yuan; Gu, Xinyue; Wang, Yanchen; Yang, Tongling; Lu, Yao; Zhou, Wenhao; Chen, Chao; Lee, Shoo K.; Du, Lizhong; Xu, Fei; Tian, Xiuying; Ji, Yong Bae; Li, Zhankui; Shi, Jingyun; Xue, Xindong; Yang, Chuanzhong; Chen, Dongmei; Wang, Sannan; Liu, Ling; Gao, Xirong; Yang, Chang-Yi; Han, Song; Shan, Ruo-Bing; Jiang, Hong; Qiu, Gang; Wei, Qiufen; Cheng, Rui; Kang, Wenqing; Li, Mingxia; Dai, Yiheng; Wang, Lili; Liu, Jiang-Qin; Lin, Zhenlang; Cheng, Xiuyong; Pan, Jiahua; Zhang, Qin; Feng, Xing; Zhou, Qin; Li, Long; Chen, Ping-Yang; Yang, Ling; Zhuang, Deyi; Zhang, Yongjun; Feng, Jinxing; Li, Li; Lin, Xin-Zhu; Qiu, Yinping; Liang, Kun; Ma, Li; Chen, Liping; Zhang, Liyan; Hong-xia, Song; Zhang, Yin; Huang, Huiwen; Yang, Jie; Liu, Dong; Ding, Guofang; Wang, Jimei; Zhang, Qianshen

doi:10.3389/fped.2021.711200

Cited by 19 publications

(8 citation statements)

References 16 publications

(25 reference statements)

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“…There were 57 hospitals in 2019 and 70 hospitals in 2020 enrolled in CHNN, covering major tertiary perinatal centers and free-standing children’s hospitals from 25 provinces across China. A standardized neonatal database has been established by CHNN to monitor outcomes and clinical practices of all preterm infants born with GA <32 weeks or birth weight <1,500 g and admitted to participating hospitals ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

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Spontaneous intestinal perforation among very preterm infants in China: a multicenter cohort study

Mao,

Jiang,

Shen

et al. 2024

Transl Pediatr

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Background Spontaneous intestinal perforation (SIP) is one of the most serious surgical bowel conditions affecting preterm infants. There are limited data on the mortality and morbidities of very preterm infants [VPIs, <32 weeks’ gestational age (GA)] with SIP in China. The study aimed to describe the prevalence, treatment, and outcomes of SIP among VPIs in China. Methods This retrospective cohort study included all infants born at 24 +0 –31 +6 weeks GA from January 1, 2019, to December 31, 2020, and admitted within seven days after birth to the neonatal intensive care units in the Chinese Neonatal Network. The primary outcome was survival without major morbidities. The association between SIP and neonatal outcomes was evaluated using multivariate logistic regression controlling for possible confounders. Results Out of the 15,814 enrolled infants, 150 (1.0%) developed SIP with a median onset age of four (IQR 2–6) days. Infants with GA 24 +0 –25 +6 weeks had the highest incidence of SIP (13/532, 2.4%), followed by those with GA 26 +0 –27 +6 weeks (22/2,005, 1.1%), 28 +0 –29 +6 weeks (44/5,269, 0.8%) and 30 +0 –31 +6 weeks (71/8,008, 0.9%). Ten SIP cases were lost to follow-up with unknown survival status and 41 (29.3%) of the remaining 140 infants with SIP died during hospitalization. Only 29.3% of infants with SIP survived without major morbidities, significantly lower than those without SIP (59.2%; P<0.01). Multivariate analysis revealed SIP was associated with a higher risk of overall death (adjusted OR 3.36; 95% CI: 1.85 to 6.08), late-onset sepsis (adjusted OR 2.10; 95% CI: 1.02 to 4.31), and bronchopulmonary dysplasia (adjusted OR 2.49; 95% CI: 1.44 to 4.30). Among all infants with SIP, 28 (18.7%) did not receive any surgical intervention. Laparotomy was provided to 113 (92.6%) of the remaining 122 infants, solely (84/122, 68.9%) or following peritoneal drainage (29/122, 23.8%), while nine (7.4%) infants underwent peritoneal drainage only. Conclusions Around 1% of VPIs in China developed SIP, associated with increased risk of mortality and morbidities. Over 90% of VPIs with SIP underwent laparotomy as initial or subsequent surgical treatment. Effective and evidence-based strategies are needed for the prevention and management of SIP.

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Section: Methodsmentioning

confidence: 99%

“…Operations and definitions of each item in the program were elucidated by a standard manual. Patient identities were kept confidential when retrieved for analysis ( 19 ). The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013).…”

Section: Methodsmentioning

confidence: 99%

Spontaneous intestinal perforation among very preterm infants in China: a multicenter cohort study

Mao,

Jiang,

Shen

et al. 2024

Transl Pediatr

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“…The identities of the patients were kept confidential. Data were directly entered into a custom database that possessed built-in error checking and a standard operations and definition manual [ 19 ]. The data then were transmitted electronically to the CHNN coordination center of the Children's Hospital of Fudan University.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of home oxygen therapy for preterm infants with bronchopulmonary dysplasia in China: results of a multicenter cohort study

et al. 2022

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Background Home oxygen therapy (HOT) is indicated upon discharge in some preterm infants with severe bronchopulmonary dysplasia (BPD). There is a lack of evidence-based consensus on the indication for HOT among these infants. Because wide variation in the institutional use of HOT exists, little is known about the role of regional social-economic level in the wide variation of HOT. Methods This was a secondary analysis of Chinese Neonatal Network (CHNN) data from January 1, 2019 to December 31, 2019. Infants at gestational ages < 32 weeks, with a birth weight < 1500 g, and with moderate or severe BPD who survived to discharge from tertiary hospitals located in 25 provinces were included in this study. Infants with major congenital anomalies and those who were discharged against medical advice were excluded. Results Of 1768 preterm infants with BPD, 474 infants (26.8%) were discharged to home with oxygen. The proportion of HOT use in participating member hospitals varied from 0 to 89%, with five of 52 hospitals’ observing proportions of HOT use that were significantly greater than expected, with 14 hospitals with observing proportions significantly less than expected, and with 33 hospitals with appropriate proportions. We noted a negative correlation between different performance groups of HOT and median GDP per capita (P = 0.04). Conclusions The use of HOT varied across China and was negatively correlated with the levels of provincial economic levels. A local HOT guideline is needed to address the wide variation in HOT use with respect to different regional economic levels in countries like China.

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“…Periodic data audits and data correction in each year were conducted to ensure data quality. [11,12]…”

Section: Data Collection and Data Quality Controlmentioning

confidence: 99%

Use of antenatal corticosteroids among infants during gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study

Zhao

Feng

Dai

et al. 2023

Chinese Medical Journal

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Background:Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China.Methods:This cross-sectional study enrolled all infants born at 24+0 to 31+6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.Results:A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks’ gestation to 3120/3960 (78.8%) at 30 to 31 weeks’ gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.Conclusions:The use rate of ACS remained low for infants at 24 to 31 weeks’ gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.

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Data Quality Improvement and Internal Data Audit of the Chinese Neonatal Network Data Collection System

Cited by 19 publications

References 16 publications

Spontaneous intestinal perforation among very preterm infants in China: a multicenter cohort study

Spontaneous intestinal perforation among very preterm infants in China: a multicenter cohort study

Characteristics of home oxygen therapy for preterm infants with bronchopulmonary dysplasia in China: results of a multicenter cohort study

Use of antenatal corticosteroids among infants during gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study

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