Problems with primary care data quality: osteoporosis as an exemplar.
OBJECTIVE
To report problems implementing a data quality programme in osteoporosis.


METHODS
Analysis of data extracted using Morbidity Information Query and Export Syntax (MIQUEST) from participating general practices' systems and recommendations of practitioners who attended an action research workshop.


METHODS
Computerised general practices using different Read code versions to record structured data.


METHODS
78 practices predominantly from London and the south east, with representation from north east, north west and south west England.


METHODS
Patients at risk can be represented in many ways within structured data. Although fracture data exists, it is unclear which are fragility fractures. T-scores, the gold standard for measuring bone density, cannot be extracted using the UK's standard data extraction tool, MIQUEST; instead manual searches had to be implemented. There is a hundredfold variation in data recording levels between practices. Therapy is more frequently recorded than diagnosis. A multidisciplinary forum of experienced practitioners proposed that a limited list of codes should be used.


CONCLUSIONS
There is variability in inter-practice data quality. Some clinically important codes are lacking, and there are multiple ways that the same clinical concept can be represented. Different practice computer systems have different versions of Read code, making some data incompatible. Manual searching is still required to find data. Clinicians with an understanding of what data are clinically relevant need to have a stronger voice in the production of codes, and in the creation of recommended lists.
de Lusignan
Simon
S
Primary Care Informatics, Department of Community Health Sciences, St George's Hospital Medical School, London, UK. slusigna@sghms.ac.uk
Valentin
Tom
T
Chan
Tom
T
Hague
Nigel
N
Wood
Oliver
O
van Vlymen
Jeremy
J
Dhoul
Neil
N
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D004739:England / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D006801:Humans; D016347:Medical Records Systems, Computerized; D010024:Osteoporosis / Q000145:classification* / Q000209:etiology; D011786:Quality Control; D009626:Terminology as Topic