title: Agreement between routine electronic hospital discharge and Scottish Stroke Care Audit (SSCA) data in identifying stroke in the Scottish population.
abstract: BACKGROUND
  In Scotland all non-obstetric, non-psychiatric acute inpatient and day case stays are recorded by an administrative hospital discharge database, the Scottish Morbidity Record (SMR01). The Scottish Stroke Care Audit (SSCA) collects data from all hospitals managing acute stroke in Scotland to support and improve quality of stroke care. The aim was to assess whether there were discrepancies between these data sources for admissions from 2010 to 2011.
  
  
  METHODS
  Records were matched when admission dates from the two data sources were within two days of each other and if an International Classification of Diseases (ICD) code of I61, I63, I64, or G45 was in the primary or secondary diagnosis field on SMR01. We also carried out a linkage analysis followed by a case-note review within one hospital in Scotland.
  
  
  RESULTS
  There were a total of 22 416 entries on SSCA and 22 200 entries on SMR01. The concordance between SSCA and SMR01 was 16 823. SSCA contained 5593 strokes that were not present in SMR01, whereas SMR01 contained 185 strokes that were not present in SSCA. In the case-note review the concordance was 531, with SSCA containing 157 strokes that were not present in SMR01 and SMR01 containing 32 strokes that were not present in SSCA.
  
  
  CONCLUSIONS
  When identifying strokes, hospital administrative discharge databases should be used with caution. Our results demonstrate that SSCA most accurately represents the number of strokes occurring in Scotland. This resource is useful for determining the provision of adequate patient care, stroke services and resources, and as a tool for research.
authors.affiliation: Division of Applied Medicine, Department of Medicine and Therapeutics, Polwarth Building, Foresterhill, University of Aberdeen, Aberdeen, UK. m.e.turner@abdn.ac.uk.
authors.forename: Melanie
authors.initials: M
authors.lastname: Turner
authors.affiliation: NHS Lanarkshire Stroke MCN, Stroke Unit, Monklands Hospital, Monkscourt Avenue, Airdrie, UK. mark.barber@nhs.net.
authors.forename: Mark
authors.initials: M
authors.lastname: Barber
authors.affiliation: Information Services Division, NHS National Services Scotland, Edinburgh, UK. hazeldodds@nhs.net.
authors.forename: Hazel
authors.initials: H
authors.lastname: Dodds
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK. martin.dennis@ed.ac.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: Dennis
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow, UK. Peter.Langhorne@glasgow.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Langhorne
authors.affiliation: Division of Applied Medicine, Department of Medicine and Therapeutics, Polwarth Building, Foresterhill, University of Aberdeen, Aberdeen, UK. m.j.macleod@abdn.ac.uk.
authors.forename: Mary-Joan
authors.initials: MJ
authors.lastname: Macleod
mesh_terms: D003625:Data Collection / Q000592:standards; D016208:Databases, Factual / Q000592:standards* / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000592:standards* / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data*; D009017:Morbidity; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012606:Scotland / Q000453:epidemiology; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*