Abstract
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). 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. 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. 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.
Highlights
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
General critical care units are defined as intensive care units (ICUs), combined ICU/high dependency units (HDUs) and combined general care/coronary care units admitting mixed medical/surgical patients predominantly aged older than 16 years
A summary of the performance of the Case Mix Programme Database (CMPD) against the DoCDat criteria is shown in Fig. 4 with the median and interquartile ranges from all 154 databases in DoCDat for comparison
Summary
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. Directory of Clinical Databases; HDU = high dependency unit; ICM = ICNARC Coding Method; ICNARC = Intensive Care National Audit &. (DoCDat) was established to inform researchers and clinicians of what clinical databases exist and to provide an independent assessment of their scope and quality [3]. This information is provided through a website [4]. The instrument was shown to have good face and content validity, to have no floor/ceiling effects and to be acceptable to database custodians [3]
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