The National Trauma Registry as a Canadian Spine Trauma Database: A Validation Study Using an Institutional Clinical Database

Abstract

Background: Miscoding is a common source of error in population-based registries. Given this, we performed a validation study comparing the Canadian National Trauma Registry (NTR) data based on the 10th Revision of the International Classification of Diseases coding with clinical data from an institutional database. Methods: All patients with acute spine trauma who were admitted to Toronto Western Hospital from May 2003 to April 2007 were included. Accuracy, sensitivity and specificity were estimated having chart data abstraction as the gold standard. Results: There were 92 patients with spine trauma (50 males, 42 females; ages from 16 to 102 years). The use of the NTR as a spine trauma database has an accuracy of 87%, sensitivity of 89.8% and specificity of 25%. If the same database is considered as a spinal cord injury (complete motor injury) database, there will be a decrease in the precision with an accuracy of 32.6%, sensitivity of 81.3% and specificity of 6.7%. Conclusions: Our results indicate that the NTR may be relatively more precise when used as a database of spine trauma in comparison with its use as a spinal cord injury database. However, the low specificity suggests that the NTR should be comprehensively validated using data from the other institutions that contribute with data collection for the NTR.