Systematic review of scope and quality of electronic patient record data in primary care.
OBJECTIVE
To systematically review measures of data quality in electronic patient records (EPRs) in primary care.


METHODS
Systematic review of English language publications, 1980-2001.


METHODS
Bibliographic searches of medical databases, specialist medical informatics databases, conference proceedings, and institutional contacts.


METHODS
Studies selected according to a predefined framework for categorising review papers.


METHODS
Reference standards and measurements used to judge quality.


RESULTS
Bibliographic searches identified 4589 publications. After primary exclusions 174 articles were classified, 52 of which met the inclusion criteria for review. Selected studies were primarily descriptive surveys. Variability in methods prevented meta-analysis of results. Forty eight publications were concerned with diagnostic data, 37 studies measured data quality, and 15 scoped EPR quality. Reliability of data was assessed with rate comparison. Measures of sensitivity were highly dependent on the element of EPR data being investigated, while the positive predictive value was consistently high, indicating good validity. Prescribing data were generally of better quality than diagnostic or lifestyle data.


CONCLUSIONS
The lack of standardised methods for assessment of quality of data in electronic patient records makes it difficult to compare results between studies. Studies should present data quality measures with clear numerators, denominators, and confidence intervals. Ambiguous terms such as "accuracy" should be avoided unless precisely defined.
Fisher Medical Centre Research Unit, Skipton, North Yorkshire BD23 1EU. krish.thiru@st-marys.nhs.uk
Krish
K
Thiru
Alan
A
Hassey
Frank
F
Sullivan
D000555:Ambulatory Care Information Systems / Q000592:standards*; D003625:Data Collection / Q000592:standards; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D015203:Reproducibility of Results; D013222:State Medicine / Q000592:standards; D006113:United Kingdom