2015-2019年中国居民心脑血管事件报告数据质量分析

Data quality of acute stroke and myocardial infarction events registry in China,2015-2019

目的分析2015—2019年中国居民心脑血管事件报告数据质量。方法选取河北、江苏、浙江、湖北和四川5个省10个国家心脑血管事件报告监测点,抽取2015—2019年其辖区内1家二级及以上医疗机构报告的"脑卒中急性事件报告卡"和"急性心肌梗死事件报告卡"(来源于中国疾病预防控制中心"全民健康保障信息化疾病预防控制信息系统")若干份,利用中国疾病预防控制中心慢性非传染性疾病预防控制中心开发的"心脑血管事件质量研究信息系统",由相关人员采集相应的临床资料,复核判定报告卡填写的完整性和准确性。结果查找并复核急性脑卒中事件报告卡2184份核心变量报告完整率为100.00%,核心变量报告准确率为79.21%~95.15%,经复核有2062份是脑卒中急性发作事件,阳性预测值为94.41%(93.07%~96.14%)。2015—2019年脑卒中核心变量报告准确性呈现增高趋势(P<0.001)。查找并复核急性心肌梗死报告卡699份,核心变量报告完整率为100.00%,核心变量报告准确率为75.10%~95.42%,经复核有668份为急性心肌梗死事件,阳性预测值为95.57%(92.86%~97.45%)。2015—2019年急性心肌梗死报告卡诊断依据完整性和核心变量准确性呈现增长趋势(均P<0.001)。结论2015—2019年心脑血管事件报告卡完整性较高,报告准确性逐渐提升,仍然存在着一定比例的错报,需要进一步加强报告规范性。

Objective To evaluate the data quality of acute stroke and myocardial infarction(MI)events records in China.Methods Ten surveillance hospitals in Hebei,Jiangsu,Zhejiang,Hubei and Sichuan provinces were selected for this study.Stroke and MI event records reported between January 2015 and December 2019 were selected by quota sampling in each hospital.Data for stroke and MI event records were obtained from’National Surveillance System for Chronic Disease,China Center for Disease Control and Prevention’.The completeness and accuracy of the event records were verified according to the electronic health records via a self-developed online quality assessment system.Results A total of 2184 acute stroke records were evaluated and data were 100.00%complete for the key variables.The consistency of key variables between the reported and the actual records were 79.21%-95.15%.A total of 2062 acute stroke events were verified,the average positive predictive value was 94.41%,ranging from 93.07%to 96.14%.During 2015-2019,the accuracy of key variables of stroke reports significantly increased(P<0.001).A total of 699 acute MI event records were evaluated and all the data were completed.The consistency of key variables between the reported and the actual records were 75.10%-95.42%.A total of 668 acute MI events were verified,the average positive predictive value was 95.57%,ranging from 92.86%to 97.45%.During 2015-2019,the completeness of diagnostic criteria and the accuracy of key variables of acute MI reports significantly increased(P<0.001).Conclusion The completeness of stroke and MI events reports were high in China during 2015-2019,and the report accuracy gradually increased,yet false positive reports still existed.It is necessary to strengthen the standardized reporting of stroke and MI events.