Assessing primary care data quality

2018 ◽  
Vol 31 (3) ◽  
pp. 203-213
Author(s):  
Yvonne Mei Fong Lim ◽  
Maryati Yusof ◽  
Sheamini Sivasampu

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Author(s):  
Matthew Johnson ◽  
Lucy Rigge ◽  
David Culliford ◽  
Lynn Josephs ◽  
Mike Thomas ◽  
...  

AbstractMost clinical contacts with chronic obstructive pulmonary disease (COPD) patients take place in primary care, presenting opportunity for proactive clinical management. Electronic health records could be used to risk stratify diagnosed patients in this setting, but may be limited by poor data quality or completeness. We developed a risk stratification database algorithm using the DOSE index (Dyspnoea, Obstruction, Smoking and Exacerbation) with routinely collected primary care data, aiming to calculate up to three repeated risk scores per patient over five years, each separated by at least one year. Among 10,393 patients with diagnosed COPD, sufficient primary care data were present to calculate at least one risk score for 77.4%, and the maximum of three risk scores for 50.6%. Linked secondary care data revealed primary care under-recording of hospital exacerbations, which translated to a slight, non-significant cohort average risk score reduction, and an understated risk group allocation for less than 1% of patients. Algorithmic calculation of the DOSE index is possible using primary care data, and appears robust to the absence of linked secondary care data, if unavailable. The DOSE index appears a simple and practical means of incorporating risk stratification into the routine primary care of COPD patients, but further research is needed to evaluate its clinical utility in this setting. Although secondary analysis of routinely collected primary care data could benefit clinicians, patients and the health system, standardised data collection and improved data quality and completeness are also needed.


2018 ◽  
Vol 31 (5) ◽  
pp. 653-660 ◽  
Author(s):  
Rachel C. Ambagtsheer ◽  
Justin Beilby ◽  
Julia Dabravolskaj ◽  
Marjan Abbasi ◽  
Mandy M. Archibald ◽  
...  

2021 ◽  
Vol 27 (2) ◽  
pp. 143
Author(s):  
Abhijeet Ghosh ◽  
Elizabeth Halcomb ◽  
Sandra McCarthy ◽  
Christine Ashley

General practice data provide important opportunities for both population health and within-practice initiatives to improve health. Despite its promise, a lack of accuracy affects the use of such data. The Sentinel Practices Data Sourcing (SPDS) project is a structured chronic disease surveillance and data quality improvement strategy in general practice. A mixed-methods approach was used to evaluate data quality improvement in 99 participating practices over 12 months. Quantitative data were obtained by measuring performance against 10 defined indicators, whereas 48 semi-structured interviews provided qualitative data. Aggregated scores demonstrated improvements in all indicators, ranging from minor to substantially significant improvements. Participants reported positively on levels of support provided, and acquisition of new knowledge and skills relating to data entry and cleansing. This evaluation provides evidence of the effectiveness of a structured approach to improve the quality of primary care data. Investing in this targeted intervention has the potential to create sustained improvements in data quality, which can drive clinical practice improvement.


2004 ◽  
Vol 12 (3) ◽  
pp. 147-156 ◽  
Author(s):  
Simon DeLusignan ◽  
Tom Valentin ◽  
Tom Chan ◽  
Nigel Hague ◽  
Oliver Wood ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035678
Author(s):  
Michael Harris ◽  
Mette Brekke ◽  
Geert-Jan Dinant ◽  
Magdalena Esteva ◽  
Robert Hoffman ◽  
...  

ObjectivesCancer survival rates vary widely between European countries, with differences in timeliness of diagnosis thought to be one key reason. There is little evidence on the way in which different healthcare systems influence primary care practitioners’ (PCPs) referral decisions in patients who could have cancer.This study aimed to explore PCPs’ diagnostic actions (whether or not they perform a key diagnostic test and/or refer to a specialist) in patients with symptoms that could be due to cancer and how they vary across European countries.DesignA primary care survey. PCPs were given vignettes describing patients with symptoms that could indicate cancer and asked how they would manage these patients. The likelihood of taking immediate diagnostic action (a diagnostic test and/or referral) in the different participating countries was analysed. Comparisons between the likelihood of taking immediate diagnostic action and physician characteristics were calculated.SettingCentres in 20 European countries with widely varying cancer survival rates.ParticipantsA total of 2086 PCPs answered the survey question, with a median of 72 PCPs per country.ResultsPCPs’ likelihood of immediate diagnostic action at the first consultation varied from 50% to 82% between countries. PCPs who were more experienced were more likely to take immediate diagnostic action than their peers.ConclusionWhen given vignettes of patients with a low but significant possibility of cancer, more than half of PCPs across Europe would take diagnostic action, most often by ordering diagnostic tests. However, there are substantial between-country variations.


Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001459
Author(s):  
Jelle C L Himmelreich ◽  
Wim A M Lucassen ◽  
Ralf E Harskamp ◽  
Claire Aussems ◽  
Henk C P M van Weert ◽  
...  

AimsTo validate a multivariable risk prediction model (Cohorts for Heart and Aging Research in Genomic Epidemiology model for atrial fibrillation (CHARGE-AF)) for 5-year risk of atrial fibrillation (AF) in routinely collected primary care data and to assess CHARGE-AF’s potential for automated, low-cost selection of patients at high risk for AF based on routine primary care data.MethodsWe included patients aged ≥40 years, free of AF and with complete CHARGE-AF variables at baseline, 1 January 2014, in a representative, nationwide routine primary care database in the Netherlands (Nivel-PCD). We validated CHARGE-AF for 5-year observed AF incidence using the C-statistic for discrimination, and calibration plot and stratified Kaplan-Meier plot for calibration. We compared CHARGE-AF with other predictors and assessed implications of using different CHARGE-AF cut-offs to select high-risk patients.ResultsAmong 111 475 patients free of AF and with complete CHARGE-AF variables at baseline (17.2% of all patients aged ≥40 years and free of AF), mean age was 65.5 years, and 53% were female. Complete CHARGE-AF cases were older and had higher AF incidence and cardiovascular comorbidity rate than incomplete cases. There were 5264 (4.7%) new AF cases during 5-year follow-up among complete cases. CHARGE-AF’s C-statistic for new AF was 0.74 (95% CI 0.73 to 0.74). The calibration plot showed slight risk underestimation in low-risk deciles and overestimation of absolute AF risk in those with highest predicted risk. The Kaplan-Meier plot with categories <2.5%, 2.5%–5% and >5% predicted 5-year risk was highly accurate. CHARGE-AF outperformed CHA2DS2-VASc (Cardiac failure or dysfunction, Hypertension, Age >=75 [Doubled], Diabetes, Stroke [Doubled]-Vascular disease, Age 65-74, and Sex category [Female]) and age alone as predictors for AF. Dichotomisation at cut-offs of 2.5%, 5% and 10% baseline CHARGE-AF risk all showed merits for patient selection in AF screening efforts.ConclusionIn patients with complete baseline CHARGE-AF data through routine Dutch primary care, CHARGE-AF accurately assessed AF risk among older primary care patients, outperformed both CHA2DS2-VASc and age alone as predictors for AF and showed potential for automated, low-cost patient selection in AF screening.


2015 ◽  
Vol 64 (1/2) ◽  
pp. 82-100 ◽  
Author(s):  
Michael Calaresu ◽  
Ali Shiri

Purpose – The purpose of this article is to explore and conceptualize the Semantic Web as a term that has been widely mentioned in the literature of library and information science. More specifically, its aim is to shed light on the evolution of the Web and to highlight a previously proposed means of attempting to improve automated manipulation of Web-based data in the context of a rapidly expanding base of both users and digital content. Design/methodology/approach – The conceptual analysis presented in this paper adopts a three-dimensional model for the discussion of Semantic Web. The first dimension focuses on Semantic Web’s basic nature, purpose and history, as well as the current state and limitations of modern search systems and related software agents. The second dimension focuses on critical knowledge structures such as taxonomies, thesauri and ontologies which are understood as fundamental elements in the creation of a Semantic Web architecture. In the third dimension, an alternative conceptual model is proposed, one, which unlike more commonly prevalent Semantic Web models, offers a greater emphasis on describing the proposed structure from an interpretive viewpoint, rather than a technical one. This paper adopts an interpretive, historical and conceptual approach to the notion of the Semantic Web by reviewing the literature and by analyzing the developments associated with the Web over the past three decades. It proposes a simplified conceptual model for easy understanding. Findings – The paper provides a conceptual model of the Semantic Web that encompasses four key strata, namely, the body of human users, the body of software applications facilitating creation and consumption of documents, the body of documents themselves and a proposed layer that would improve automated manipulation of Web-based data by the software applications. Research limitations/implications – This paper will facilitate a better conceptual understanding of the Semantic Web, and thereby contribute, in a small way, to the larger body of discourse surrounding it. The conceptual model will provide a reference point for education and research purposes. Originality/value – This paper provides an original analysis of both conceptual and technical aspects of Semantic Web. The proposed conceptual model provides a new perspective on this subject.


2021 ◽  
Vol 12 ◽  
pp. 215013272110209
Author(s):  
Brigid Adviento ◽  
Michael Conner ◽  
Alexander Sarkisian ◽  
Nicolette Walano ◽  
Hans Andersson ◽  
...  

The PREMM5 model is a web-based clinical prediction algorithm that estimates the gene-specific risk of an individual carrying a Lynch syndrome germline mutation based on targeted family history questions. The objectives of our study were to determine the feasibility of screening for LS in an urban, minority patient population in a primary care setting using the PREMM5 model and characterize patient barriers associated with difficulty completing the questions. Participants were recruited from Tulane Internal Medicine primary care clinics on 9 random collection dates. Our data illustrates the difficulty patients have in recalling important details necessary to answer the PREMM questionnaire.


Author(s):  
Henry Larkin

Purpose – The purpose of this paper is to investigate the feasibility of creating a declarative user interface language suitable for rapid prototyping of mobile and Web apps. Moreover, this paper presents a new framework for creating responsive user interfaces using JavaScript. Design/methodology/approach – Very little existing research has been done in JavaScript-specific declarative user interface (UI) languages for mobile Web apps. This paper introduces a new framework, along with several case studies that create modern responsive designs programmatically. Findings – The fully implemented prototype verifies the feasibility of a JavaScript-based declarative user interface library. This paper demonstrates that existing solutions are unwieldy and cumbersome to dynamically create and adjust nodes within a visual syntax of program code. Originality/value – This paper presents the Guix.js platform, a declarative UI library for rapid development of Web-based mobile interfaces in JavaScript.


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