Reliability of Routinely Collected Hospital Data for Child Maltreatment Surveillance 英文参考文献.docVIP

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Reliability of Routinely Collected Hospital Data for Child Maltreatment Surveillance 英文参考文献.doc

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Reliability of Routinely Collected Hospital Data for Child Maltreatment Surveillance 英文参考文献

McKenzieetal.BMCPublicHealth2011,11:8 /1471-2458/11/8 RESEARCH ARTICLE OpenAccess ReliabilityofRoutinelyCollectedHospitalDatafor ChildMaltreatmentSurveillance KirstenMcKenzie*,DebbieAScott,GarrySWaller,MargaretCampbell Abstract Background:Internationally,researchonchildmaltreatment-relatedinjurieshasbeenhamperedbyalackof availableroutinelycollectedhealthdatatoidentifycases,examinecauses,identifyriskfactorsandexplorehealth outcomes.RoutinelycollectedhospitalseparationdatacodedusingtheInternationalClassificationofDiseasesand RelatedHealthProblems(ICD)systemprovideaninternationallystandardiseddatasourceforclassifyingand aggregatingdiseases,injuries,causesofinjuriesandrelatedhealthconditionsforstatisticalpurposes.However, therehasbeenlimitedresearchtoexaminethereliabilityofthesedataforchildmaltreatmentsurveillance purposes.ThisstudyexaminedthereliabilityofcodingofchildmaltreatmentinQueensland,Australia. Methods:Aretrospectivemedicalrecordreviewandrecodingmethodologywasusedtoassessthereliabilityof codingofchildmaltreatment.AstratifiedsampleofhospitalsacrossQueenslandwasselectedforthisstudy,anda stratifiedrandomsampleofcaseswasselectedfromwithinthosehospitals. Results:In3.6%ofcasesthecodersdisagreedonwhetheranymaltreatmentcodecouldbeassigned(definiteor possible)versusnomaltreatmentbeingassigned(unintentionalinjury),givingasensitivityof0.982andspecificity of0.948.Thereviewofthesecaseswherediscrepanciesexistedrevealedthatallcaseshadsomeindicationsofrisk documentedintherecords.15.5%ofcasesoriginallyassignedadefiniteorpossiblemaltreatmentcode,were recodedtoamoreorlessdefinitestrata.Intermsofthenumberandtypeofmaltreatmentcodesassigned,the auditorassignedagreaternumberofmaltreatmenttypesbasedonthemedicaldocumentationthantheoriginal coderassigned(22%oftheauditorcodedcaseshadmorethanonemaltreatmenttypeassignedcomparedto only6%oftheoriginalcodeddata).Themaltreatmenttypeswhichwerethemost‘under-coded’bytheoriginal coderwerepsychologicalabuseandneglect.Casescodedwithasexualabuseco