Abstract 13246: Data Quality in the American Heart Association Get With the Guidelines-Stroke: Results from a National Data Validation Audit
Background: Get With The Guidelines-Stroke (GWTG-Stroke) is a national stroke registry and quality improvement program developed by the AHA. We examined the accuracy and reliability of data entered in the registry.
Methods: Data entered by sites in the database were compared to that abstracted from de-identified medical records by trained auditors. Accuracy for each individual data element and a composite accuracy measure, defined as the total number of accurate data elements divided by the total number of possible data elements among eligible records, were calculated. Reliability was assessed using κ statistics for categorical variables and intraclass correlation (ICC) for continuous variables.
Results: A random selection of 441 medical records from 147 hospitals were available for auditing. Overall accuracy was above 90% for all variables abstracted, for example clinical diagnosis (92.7%), initial NIHSS (93.6%), arrival date/time (93.6%), and date/time IV tPA initiated (99.5%). Exceptions included weight (84.9%), creatinine (88.1%), and date/time last known well (85.3%). The composite accuracy rate was 96.1%. The composite measure varied slightly by region and hospital academic status. There were no accuracy differences by bed size, ischemic stroke volume, TJC primary stroke center certification, or Coverdell registry participation (Table). Excepting serum creatinine (ICC=0.04), intermediate to good (κ or ICC=0.40-0.75), or excellent agreement (κ or ICC≥0.75) were observed across all audited variables, including time-related performance measures, such as arrival within 2 hours of symptom onset (κ=0.90) and door to needle time ≤60 minutes (κ=0.72).
Conclusions: This audit establishes reliability of GWTG-Stroke registry data and contributes to the utility of this data resource for use in research and national surveillance of stroke care. Individual data elements with suboptimal accuracy should be targeted for further data quality improvement.
- © 2011 by American Heart Association, Inc.