Data verification of nationwide clinical quality registries

Werf, Leonie R. van der; Voeten, Stijn C.; Loe, C.M.M. van; Karthaus, E.G.; Wouters, Michel W. J. M.; Prins, Hubert A.

doi:10.1002/bjs5.50209

Cited by 53 publications

(46 citation statements)

References 10 publications

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“…The original data was compared with data registered in the DUCA. 6 In the present study, the accuracy with regard to registration of postoperative complications, 30-day mortality, reinterventions, readmissions, number of lymph nodes, resections margin, and ASA score (the physical status classification according to the American Society of Anesthesiologists) was tested. The accuracy was estimated by the number of discrepancies found against the total number of patients in the sample.…”

Section: Data Verificationmentioning

confidence: 99%

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

et al. 2019

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Objective: This nationwide population-based study aimed to report postoperative morbidity and mortality after esophagectomy and gastrectomy in the Netherlands according to the definitions of the Esophagectomy Complications Consensus Group (ECCG). Background: To standardize international outcome reporting in esophageal surgery, the ECCG developed a standardized outcomes set. Methods: For this national cohort study, all patients undergoing esophagectomy or gastrectomy for cancer between 2016 and 2017 were selected from the Dutch Upper gastrointestinal Cancer Audit. In a random sample of hospitals, data completeness and accuracy were validated by reabstraction of the data. The investigated outcomes in the present study were postoperative complications, major complications (Clavien-Dindo grade !III), and 30-day mortality, according to definitions of the ECCG. Results: A total of 2545 patients from 22 hospitals were included. The completeness of the Dutch Upper gastrointestinal Cancer Audit was estimated at 99.8%. Data accuracy on different items was 94% to 100%. After esophagectomy, 1046 of 1617 patients (65%) had a postoperative complication including 468 patients (29%) with a major complication. Most common complications were pneumonia (21%), esophago-enteric leak from anastomosis, staple line or localized conduit necrosis (19%), and atrial dysrhythmia (15%). The 30-day mortality was 1.7%. After gastrectomy, 397 of 928 patients (42%) had a postoperative complication including 180 patients (19%) with a major complication. Most common complications were pneumonia (12%), esophago-enteric leak from anastomosis, staple line or localized conduit necrosis (9%), and acute delirium (5%). The 30-day mortality was 4.4%. Conclusions: Reporting complications according to the ECCG platform is feasible in the Netherlands and facilitates international benchmarking.

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Section: Data Verificationmentioning

confidence: 99%

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

et al. 2019

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“…Verification of the DSAA data was carried out in 2015 by a third trusted party, through a random sample of hospitals. 12,13…”

Section: Data Source Participants and Settingmentioning

confidence: 99%

Patients with a Ruptured Abdominal Aortic Aneurysm Are Better Informed in Hospitals with an “EVAR-preferred” Strategy: An Instrumental Variable Analysis of the Dutch Surgical Aneurysm Audit

Karthaus¹,

Lijftogt²,

Willik³

et al. 2020

Annals of Vascular Surgery

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Background: While several observational studies suggested a lower postoperative mortality after minimal invasive endovascular aneurysm repair (EVAR) in patients with a ruptured abdominal aortic aneurysm (RAAA) compared to conventional open surgical repair (OSR), landmark randomized controlled trials have not been able to prove the superiority of EVAR over OSR. Randomized controlled trials contain a selected, homogeneous population, influencing external validity. Observational studies are biased and adjustment of confounders can be incomplete. Instrumental variable (IV) analysis (pseudorandomization) may help to answer the question if patients with an RAAA have lower postoperative mortality when undergoing EVAR compared to OSR. Methods: This is an observational study including all patients with an RAAA, registered in the Dutch Surgical Aneurysm Audit between 2013 and 2017. The risk difference (RD) in postoperative mortality (30 days/in-hospital) between patients undergoing EVAR and OSR was estimated, in which adjustment for confounding was performed in 3 ways: linear model adjusted for observed confounders, propensity score model (multivariable logistic regression analysis), and IV analysis (two-stage least square regression), adjusting for observed and unobserved confounders, with the variation in percentage of EVAR per hospital as the IV instrument. Results: 2419 patients with an RAAA (1489 OSR and 930 EVAR) were included. Unadjusted postoperative mortality was 34.9% after OSR and 22.6% after EVAR (RD 12.3%, 95% CI 8.5e16%). The RD adjusted for observed confounders using linear regression analysis and propensity score analysis was, respectively, 12.3% (95% CI 9.6e16.7%) and 13.2% (95%CI 9.3e 17.1%) in favor of EVAR. Using IV analysis, adjusting for observed and unobserved confounders, RD was 8.9% (95% CI-1.1e18.9%) in favor of EVAR.

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“…11 Data verification was performed to provide insight in the completeness and accuracy of the DHBA. 11,12 Ethical approval was considered unnecessary under Dutch law as the audit is part of the Dutch Inspectorate of Health Care and provides an anonymized dataset.…”

Section: Methodsmentioning

confidence: 99%

Hospital variation in combined liver resection and thermal ablation for colorectal liver metastases and impact on short-term postoperative outcomes: a nationwide population-based study

Elfrink

Nieuwenhuizen

Tol

et al. 2021

HPB

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Background: Combining resection and thermal ablation can improve short-term postoperative outcomes in patients with colorectal liver metastases (CRLM). This study assessed nationwide hospital variation and short-term postoperative outcomes after combined resection and ablation. Methods: In this population-based study, all CRLM patients who underwent resection in the Netherlands between 2014 and 2018 were included. After propensity score matching for age, ASA-score, Charlson-score, diameter of largest CRLM, number of CRLM and earlier resection, postoperative outcomes were compared. Postoperative complicated course (PCC) was defined as discharge after 14 days or a major complication or death within 30 days of surgery. Results: Of 4639 included patients, 3697 (80%) underwent resection and 942 (20%) resection and ablation. Unadjusted percentage of patients who underwent resection and ablation per hospital ranged between 4 and 44%. Hospital variation persisted after case-mix correction. After matching, 734 patients remained in each group. Hospital stay (median 6 vs. 7 days, p = 0.011), PCC (11% vs. 14.7%, p = 0.043) and 30-day mortality (0.7% vs. 2.3%, p = 0.018) were lower in the resection and ablation group. Differences faded in multivariable logistic regression due to inclusion of major hepatectomy. Conclusion: Significant hospital variation was observed in the Netherlands. Short-term postoperative outcomes were better after combined resection and ablation, attributed to avoiding complications associated with major hepatectomy.

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Data verification of nationwide clinical quality registries

Cited by 53 publications

References 10 publications

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

Reporting National Outcomes After Esophagectomy and Gastrectomy According to the Esophageal Complications Consensus Group (ECCG)

Patients with a Ruptured Abdominal Aortic Aneurysm Are Better Informed in Hospitals with an “EVAR-preferred” Strategy: An Instrumental Variable Analysis of the Dutch Surgical Aneurysm Audit

Hospital variation in combined liver resection and thermal ablation for colorectal liver metastases and impact on short-term postoperative outcomes: a nationwide population-based study

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