CAJ | 학술논문

北京市出院病例监测系统中急性卒中病例诊断质量评价
북경시출원병례감측계통중급성졸중병례진단질량평개
Validation of Stroke Diagnosis in Beijing Hospital Discharge Register Database

万方数据

中国卒中杂志中國卒中雜誌 중국졸중잡지
CHINESE JOURNAL OF STROKE
2014年 9期 731-735 ,共5页

潘岳松%刘改芬%张润华%谢学勤%郑健鹏%魏娜%马越涛%张婧%冀瑞俊%王伊龙%赵性泉%王拥军

반악송%류개분%장윤화%사학근%정건붕%위나%마월도%장청%기서준%왕이룡%조성천%왕옹군

出院登记%诊断质量%疾病监测%卒中齣院登記%診斷質量%疾病鑑測%卒中
출원등기%진단질량%질병감측%졸중
Discharge register%Quality of diagnosis%Disease monitoring%Stroke

目的评价北京市出院病例监测系统卒中的诊断质量，为利用数据库开展卒中发病流行病学监测提供数据质量评价证据。 　　方法采用按病历号完全随机抽样的方法在出院病例数据库中抽取15家医院1433份急性卒中病例（2007年704份，2010年729份）。以专家组查阅原始病案资料重新诊断结果为金标准，评价诊断的一致性。 　　结果第一诊断与专家核查结果符合率为73.1%（95%可信区间：70.7%～75.4%）。缺血性脑血管病的诊断符合率总体低于出血性脑血管病。第一诊断与专家核查结果不符病例的正确诊断主要是诊断证据不足、头晕、既往脑梗死本次非急性发作等。 　　结论出院病例数据库卒中诊断总体具有较高的阳性预测值，在利用出院病例数据库数据进行人群卒中发病监测时应进行适当的纠正。
목적평개북경시출원병례감측계통졸중적진단질량，위이용수거고개전졸중발병류행병학감측제공수거질량평개증거。 　　방법채용안병력호완전수궤추양적방법재출원병례수거고중추취15가의원1433빈급성졸중병례（2007년704빈，2010년729빈）。이전가조사열원시병안자료중신진단결과위금표준，평개진단적일치성。 　　결과제일진단여전가핵사결과부합솔위73.1%（95%가신구간：70.7%～75.4%）。결혈성뇌혈관병적진단부합솔총체저우출혈성뇌혈관병。제일진단여전가핵사결과불부병례적정학진단주요시진단증거불족、두훈、기왕뇌경사본차비급성발작등。 　　결론출원병례수거고졸중진단총체구유교고적양성예측치，재이용출원병례수거고수거진행인군졸중발병감측시응진행괄당적규정。
Objective To estimate the validation of stroke diagnosis in Beijing Hospital Discharge Register Database, and to provide evidence of data quality for epidemiology monitoring of incidence of stroke using this administrative database. Methods One thousand four hundred and thirty-three stroke patients (704 reported in 2007, 729 reported in 2010) in 15 hospitals in Beijing were randomly sampled from Beijing Hospital Discharge Register Database. The agreements of diagnosis were assessed using the results of expert re-diagnosis after reviewing the medical records in detail as the gold standard. Results The agreement rate of ifrst diagnosis recorded in the database and result of expert re-diagnosis was 73.1% (95% confidence interval:70.7%~75.4%). The agreement rate of ischemic cerebrovascular disease was lower than that of hemorrhagic cerebrovascular disease. The main correct diagnoses of diagnosis inconsistency cases were lack of evidence for diagnosis, dizziness, established ischemic stroke without attack before this hospitalization. Conclusion The positive predictive value of the hospital discharge register database is fairly good. Certain adjustments are required when the administrative register database is used for the monitoring of stroke incidence.