(Dis)concordance of comorbidity data and cancer status across administrative datasets, medical charts, and self-reports.

Abstract

BACKGROUND:

Benchmarking outcomes across settings commonly requires risk-adjustment for co-morbidities that must be derived from extant sources that were designed for other purposes. A question arises as to the extent to which differing available sources for health data will be concordant when inferring the type and severity of co-morbidities, how close are these to the "truth". We studied the level of concordance for same-patient comorbidity data extracted from administrative data (coded from International Classification of Diseases, Australian modification,10th edition [ICD-10 AM]), from the medical chart audit, and data self-reported by men with prostate cancer who had undergone a radical prostatectomy.

METHODS:

We included six hospitals (5 public and 1 private) contributing to the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic) in the study. Eligible patients from the PCOR-Vic underwent a radical prostatectomy between January 2017 and April 2018.Health Information Manager's in each hospital, provided each patient's associated administrative ICD-10 AM comorbidity codes. Medical charts were reviewed to extract comorbidity data. The self-reported comorbidity questionnaire (SCQ) was distributed through PCOR-Vic to eligible men.

RESULTS:

The percentage agreement between the administrative data, medical charts and self-reports ranged from 92 to 99% in the 122 patients from the 217 eligible participants who responded to the questionnaire. The presence of comorbidities showed a poor level of agreement between data sources.

CONCLUSION:

Relying on a single data source to generate comorbidity indices for risk-modelling purposes may fail to capture the reality of a patient's disease profile. There does not appear to be a 'gold-standard' data source for the collection of data on comorbidities.

• Authors: A Sheriffdeen, J L Millar, C Martin, M Evans, G Tikellis, S M Evans
• Journal: BMC health services research (BMC Health Serv Res) Vol. 20 Issue 1 Pg. 858 (Sep 11 2020) ISSN: 1472-6963 [Electronic] England
• PMID: 32917193 (Publication Type: Journal Article)

Topics

• Aged
• Australia (epidemiology)
• Cohort Studies
• Comorbidity
• Humans
• International Classification of Diseases
• Male
• Medical Audit
• Medical Records (statistics & numerical data)
• Middle Aged
• Prostatectomy
• Prostatic Neoplasms (epidemiology)
• Retrospective Studies
• Self Report (statistics & numerical data)