Abstract
BackgroundMedical quality registers are useful sources of knowledge about diseases and the health services. However, there are challenges in obtaining valid and reliable data. This study aims to assess the reliability in a national medical quality register.MethodsWe randomly selected 111 patients having had a stroke in 2012. An experienced stroke nurse completed the Norwegian Stroke Register paper forms for all 111 patients by review of the medical records. We then extracted all registered data on the same patients from the Norwegian Stroke Register and calculated Cohen’s kappa and Gwet’s AC1 with 95 % confidence intervals for 51 nominal variables and Cohen’s quadratic weighted kappa and Gwet’s AC2 for three ordinal variables. For two time variables, we calculated the Intraclass Correlation Coefficient.ResultsSubstantial to excellent reliability (kappa > 0.60/AC1 > 0.80) was observed for most variables related to past medical history, functional status, stroke subtype and discharge destination. Although excellent reliability was observed for time of stroke onset (ICC 0.93), this variable was hampered with a substantial amount of missing values. Some variables related to treatment and examinations in hospital displayed low levels of agreement. This applies to heart rate monitoring (kappa 0.17/AC1 0.46), swallowing test performed (kappa 0.19/AC1 0.27) and mobilized out of bed within 24 h after admission (kappa 0.04/AC1 −0.11).ConclusionA majority of the variables in The Norwegian Stroke Register have substantial to excellent reliability. The problem areas seem to be the lack of completeness in the time variable indicating stroke onset and poor reliability in some variables concerning examinations and treatment received in hospital.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1556-3) contains supplementary material, which is available to authorized users.
Highlights
Medical quality registers are useful sources of knowledge about diseases and the health services
Most of the variables in the Norwegian Stroke Register appeared to have substantial to excellent reliability, including many of the variables related to past medical history, functional status before the stroke, discharge destination, stroke subtype and drug treatment prior to the stroke
This study indicated a high degree of reliability for the date and time variables, the results suggests that steps needs to be taken to ensure more complete recordings of time of stroke onset in the Norwegian Stroke Register
Summary
Medical quality registers are useful sources of knowledge about diseases and the health services. This study aims to assess the reliability in a national medical quality register. There has been an increasing interest in medical quality registers as a tool for improving the quality of care and as sources of knowledge about diseases and of the health services. Few studies have investigated the validity of stroke registers [1], and these typically focus on calculating measures of completeness. Reeves et al found excellent inter-rater reliability for many variables, but several variables in need of improvement were identified. These include stroke onset time, stroke team consultation, time of initial brain imaging and discharge destination
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