Training in data definitions improves quality of intensive care data.
BACKGROUND
Our aim was to assess the contribution of training in data definitions and data extraction guidelines to improving quality of data for use in intensive care scoring systems such as the Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS) II in the Dutch National Intensive Care Evaluation (NICE) registry.


METHODS
Before and after attending a central training programme, a training group of 31 intensive care physicians from Dutch hospitals who were newly participating in the NICE registry extracted data from three sample patient records. The 5-hour training programme provided participants with guidelines for data extraction and strict data definitions. A control group of 10 intensive care physicians, who were trained according the to train-the-trainer principle at least 6 months before the study, extracted the data twice, without specific training in between.


RESULTS
In the training group the mean percentage of accurate data increased significantly after training for all NICE variables (+7%, 95% confidence interval 5%-10%), for APACHE II variables (+6%, 95% confidence interval 4%-9%) and for SAPS II variables (+4%, 95% confidence interval 1%-6%). The percentage data error due to nonadherence to data definitions decreased by 3.5% after training. Deviations from 'gold standard' SAPS II scores and predicted mortalities decreased significantly after training. Data accuracy in the control group did not change between the two data extractions and was equal to post-training data accuracy in the training group.


CONCLUSIONS
Training in data definitions and data extraction guidelines is an effective way to improve quality of intensive care scoring data.
Arts
Daniëlle G T
DG
Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, The Netherlands. D.G.Arts@amc.uva.nl
Bosman
Rob J
RJ
de Jonge
Evert
E
Joore
Johannes C A
JC
de Keizer
Nicolette F
NF
D018806:APACHE; D005069:Evaluation Studies as Topic; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016247:Information Storage and Retrieval; D007318:Inservice Training; D007362:Intensive Care Units; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D009426:Netherlands; D019984:Quality Indicators, Health Care; D012042:Registries; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013663:Teaching / Q000379:methods