Data quality in the American Heart Association Get with the Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit

Ying Xian, Gregg C. Fonarow, Mathew J. Reeves, Laura E. Webb, Jason Blevins, Vladimir S. Demyanenko, Xin Zhao, Daiwai M. Olson, Adrian F. Hernandez, Eric D. Peterson, Lee H. Schwamm, Eric E. Smith

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background: Get With The Guidelines (GWTG)-Stroke is a national stroke registry and quality improvement program. We examined the accuracy and reliability of data entered in GWTG-Stroke. Methods: Data entered by sites in the GWTG-Stroke database were compared with that abstracted from de-identified medical records by trained auditors. Accuracy for each individual data element and a composite accuracy measure were calculated. Reliability was assessed using kappa (κ) statistics for categorical variables and intraclass correlation (ICC) for continuous variables. Results: A random selection of 438 medical records from 147 GWTG-Stroke hospitals was obtained. Overall accuracy was above 90% for all variables abstracted except for weight (84.9%), serum creatinine (88.1%), deep venous thrombosis prophylaxis (79.0%), and date/time last known well (85.3%). Intermediate to good (κ or ICC 0.40-0.75) or excellent agreement (κ or ICC ≥0.75) was observed for nearly all audited variables, including time-related performance measures such as arrival within 2 hours of symptom onset (κ = 0.90) and door-to-needle time ≤60 minutes (κ = 0.72). The overall composite accuracy rate was 96.1%. The composite measure varied slightly by region and hospital academic status, but there were no significant differences in composite accuracy by bed size, ischemic stroke volume, primary stroke center certification, or Coverdell Registry participation. Conclusions: This audit establishes the reliability of GWTG-Stroke registry data. Individual data elements with suboptimal accuracy should be targeted for further data quality improvement.

Original languageEnglish (US)
JournalAmerican Heart Journal
Volume163
Issue number3
DOIs
StatePublished - Mar 2012

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Stroke
Guidelines
Registries
Quality Improvement
Medical Records
Hospital Bed Capacity
Certification
Data Accuracy
Venous Thrombosis
Stroke Volume
Needles
Creatinine
Databases
Weights and Measures
Serum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Data quality in the American Heart Association Get with the Guidelines-Stroke (GWTG-Stroke) : Results from a National Data Validation Audit. / Xian, Ying; Fonarow, Gregg C.; Reeves, Mathew J.; Webb, Laura E.; Blevins, Jason; Demyanenko, Vladimir S.; Zhao, Xin; Olson, Daiwai M.; Hernandez, Adrian F.; Peterson, Eric D.; Schwamm, Lee H.; Smith, Eric E.

In: American Heart Journal, Vol. 163, No. 3, 03.2012.

Research output: Contribution to journalArticle

Xian, Y, Fonarow, GC, Reeves, MJ, Webb, LE, Blevins, J, Demyanenko, VS, Zhao, X, Olson, DM, Hernandez, AF, Peterson, ED, Schwamm, LH & Smith, EE 2012, 'Data quality in the American Heart Association Get with the Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit', American Heart Journal, vol. 163, no. 3. https://doi.org/10.1016/j.ahj.2011.12.012
Xian, Ying ; Fonarow, Gregg C. ; Reeves, Mathew J. ; Webb, Laura E. ; Blevins, Jason ; Demyanenko, Vladimir S. ; Zhao, Xin ; Olson, Daiwai M. ; Hernandez, Adrian F. ; Peterson, Eric D. ; Schwamm, Lee H. ; Smith, Eric E. / Data quality in the American Heart Association Get with the Guidelines-Stroke (GWTG-Stroke) : Results from a National Data Validation Audit. In: American Heart Journal. 2012 ; Vol. 163, No. 3.
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abstract = "Background: Get With The Guidelines (GWTG)-Stroke is a national stroke registry and quality improvement program. We examined the accuracy and reliability of data entered in GWTG-Stroke. Methods: Data entered by sites in the GWTG-Stroke database were compared with that abstracted from de-identified medical records by trained auditors. Accuracy for each individual data element and a composite accuracy measure were calculated. Reliability was assessed using kappa (κ) statistics for categorical variables and intraclass correlation (ICC) for continuous variables. Results: A random selection of 438 medical records from 147 GWTG-Stroke hospitals was obtained. Overall accuracy was above 90{\%} for all variables abstracted except for weight (84.9{\%}), serum creatinine (88.1{\%}), deep venous thrombosis prophylaxis (79.0{\%}), and date/time last known well (85.3{\%}). Intermediate to good (κ or ICC 0.40-0.75) or excellent agreement (κ or ICC ≥0.75) was observed for nearly all audited variables, including time-related performance measures such as arrival within 2 hours of symptom onset (κ = 0.90) and door-to-needle time ≤60 minutes (κ = 0.72). The overall composite accuracy rate was 96.1{\%}. The composite measure varied slightly by region and hospital academic status, but there were no significant differences in composite accuracy by bed size, ischemic stroke volume, primary stroke center certification, or Coverdell Registry participation. Conclusions: This audit establishes the reliability of GWTG-Stroke registry data. Individual data elements with suboptimal accuracy should be targeted for further data quality improvement.",
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AU - Demyanenko, Vladimir S.

AU - Zhao, Xin

AU - Olson, Daiwai M.

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AB - Background: Get With The Guidelines (GWTG)-Stroke is a national stroke registry and quality improvement program. We examined the accuracy and reliability of data entered in GWTG-Stroke. Methods: Data entered by sites in the GWTG-Stroke database were compared with that abstracted from de-identified medical records by trained auditors. Accuracy for each individual data element and a composite accuracy measure were calculated. Reliability was assessed using kappa (κ) statistics for categorical variables and intraclass correlation (ICC) for continuous variables. Results: A random selection of 438 medical records from 147 GWTG-Stroke hospitals was obtained. Overall accuracy was above 90% for all variables abstracted except for weight (84.9%), serum creatinine (88.1%), deep venous thrombosis prophylaxis (79.0%), and date/time last known well (85.3%). Intermediate to good (κ or ICC 0.40-0.75) or excellent agreement (κ or ICC ≥0.75) was observed for nearly all audited variables, including time-related performance measures such as arrival within 2 hours of symptom onset (κ = 0.90) and door-to-needle time ≤60 minutes (κ = 0.72). The overall composite accuracy rate was 96.1%. The composite measure varied slightly by region and hospital academic status, but there were no significant differences in composite accuracy by bed size, ischemic stroke volume, primary stroke center certification, or Coverdell Registry participation. Conclusions: This audit establishes the reliability of GWTG-Stroke registry data. Individual data elements with suboptimal accuracy should be targeted for further data quality improvement.

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