Untitled

Abstract

Introduction The present paper describes the methods of data collection and validation employed in the Intensive Care National Audit & Research Centre Case Mix Programme (CMP), a national comparative audit of outcome for adult, critical care admissions. The paper also describes the case mix, outcome and activity of the admissions in the Case Mix Programme Database (CMPD). Methods The CMP collects data on consecutive admissions to adult, general critical care units in England, Wales and Northern Ireland. Explicit steps are taken to ensure the accuracy of the data, including use of a dataset specification, of initial and refresher training courses, and of local and central validation of submitted data for incomplete, illogical and inconsistent values. Criteria for evaluating clinical databases developed by the Directory of Clinical Databases were applied to the CMPD. The case mix, outcome and activity for all admissions were briefly summarised. Results The mean quality level achieved by the CMPD for the 10 Directory of Clinical Databases criteria was 3.4 (on a scale of 1 = worst to 4 = best). The CMPD contained validated data on 129,647 admissions to 128 units. The median age was 63 years, and 59% were male. The mean Acute Physiology and Chronic Health Evaluation II score was 16.5. Mortality was 20.3% in the CMP unit and was 30.8% at ultimate discharge from hospital. Nonsurvivors stayed longer in intensive care than did survivors (median 2.0 days versus 1.7 days in the CMP unit) but had a shorter total hospital length of stay (9 days versus 16 days). Results for the CMPD were comparable with results from other published reports of UK critical care admissions. Conclusions The CMP uses rigorous methods to ensure data are complete, valid and reliable. The CMP scores well against published criteria for high-quality clinical databases.

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

“…The CMP database contains pooled case mix data, collected from the first 24 hours following admission to the critical care unit and outcome data on consecutive admissions to units participating in the CMP. 107 The CMP database has been independently assessed to be of high quality. 108 All data used in this study were validated and from units …”

Protocolised Management In Sepsis (ProMISe): a multicentre randomised controlled trial of the clinical effectiveness and cost-effectiveness of early, goal-directed, protocolised resuscitation for emerging septic shock

“…The data set for ProMISe included the minimum data required to confirm patient eligibility, to describe the patient population, to monitor and describe delivery of the intervention, to assess primary and secondary outcomes and to enable linkage to the ICNARC Case Mix Programme, the national clinical audit of adult critical care 32 (see Appendix 3).…”

“…32 Data for the CMP are collected by trained data collectors to precise rules and definitions. The data then undergo extensive local and central validation for completeness, illogicalities and inconsistencies prior to pooling.…”

A multicentre, randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of early nutritional support via the parenteral versus the enteral route in critically ill patients (CALORIES)

“…No problems 145 (31) 159 (34) Slight problems 139 (30) 136 (29) Moderate problems 111 (23) 125 (26) Severe problems 54 (12) 42 (9) Extreme problems 18 (4) 11 (2) What is the purpose of the study?…”

“…26 The Case Mix Programme is listed in the Department of Health's 'Quality Accounts' for 2013-14 as a recognised national audit by the National Advisory Group for Clinical Audit and Enquiries.…”