PMID- 30652120
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 7
IP  - 1
DP  - 2019 Jan
TI  - Registration bias in a clinical quality register.
PG  - E90-E98
LID - 10.1055/a-0806-7006 [doi]
AB  - Background and aims  The quality of medical quality registers is poorly defined 
      and lack of trust in data due to low completeness may be a major barrier against 
      their use in quality improvement interventions. The aim of the current 
      observational study was to explore how selective reporting may influence adverse 
      events registered in the Norwegian quality register for colonoscopy (Gastronet). 
      Materials and methods  Gastronet's database includes data provided by 
      endoscopists, nurses and patients. All outpatient colonoscopies reported to 
      Gastronet in 2015 were included and compared to the total number of colonoscopies 
      performed in Norway as retrieved from the National Patient Registry. Hospitals 
      were categorized into four groups according to reporting completeness < 50 %, 
      50 % to 69 %, 70 % to 89 % and >/= 90 %. The number of recorded adverse events 
      (AEs) and procedure time were analyzed. Multivariate logistic regression models 
      were fitted to explore independent factors for selection bias. Results  A total 
      of 22,364 colonoscopies were reported to the National Patient Register of which 
      15,855 (71 %) were registered in Gastronet. Feedback was received from 11,079 
      patients (50 %). The frequency of AEs increased from 0.6 % in completeness 
      group < 50 % to 1.6 % in completeness group >/= 90 % ( P  < 0.001). Long 
      colonoscopy procedure time was associated with low reporting completeness. 
      Patient feedback was associated with older age, cecal intubation success and 
      sedation-free colonoscopy. Conclusion  Incomplete registration in a colonoscopy 
      quality register is associated with underreporting of AEs. Longer procedure time, 
      a surrogate marker for time constraint, is associated with low completeness.
FAU - Hoff, Geir
AU  - Hoff G
AD  - Telemark Hospital, Skien, Norway.
AD  - University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
FAU - de Lange, Thomas
AU  - de Lange T
AD  - University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
AD  - Oslo University Hospital, Oslo, Norway.
FAU - Bretthauer, Michael
AU  - Bretthauer M
AD  - University of Oslo, Institute of Health and Society, Oslo, Norway.
AD  - Frontier Science Boston, Boston, Massachusetts, United States.
FAU - Dahler, Stein
AU  - Dahler S
AD  - Telemark Hospital Notodden, Notodden, Norway.
FAU - Halvorsen, Fred-Arne
AU  - Halvorsen FA
AD  - Drammen Hospital, Drammen, Norway.
FAU - Huppertz-Hauss, Gert
AU  - Huppertz-Hauss G
AD  - Telemark Hospital, Skien, Norway.
FAU - Hoie, Ole
AU  - Hoie O
AD  - Sorlandet Hospital, Kristiansand, Norway.
FAU - Kjellevold, Oystein
AU  - Kjellevold O
AD  - Telemark Hospital Kragero, Kragero, Norway.
FAU - Mortiz, Volker
AU  - Mortiz V
AD  - Telemark Hospital, Skien, Norway.
FAU - Sandvei, Per
AU  - Sandvei P
AD  - Ostfold Hospital, Gralum, Norway.
FAU - Seip, Birgitte
AU  - Seip B
AD  - Vestfold Hospital, Tonsberg, Norway.
FAU - Holme, Oyvind
AU  - Holme O
AD  - Sorlandet Hospital, Kristiansand, Norway.
LA  - eng
PT  - Journal Article
DEP - 20190115
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC6333534
COIS- Competing interests Dr. Hoff received payment from AMGEN Norway in 2017 for 
      giving a lecture in 2017.
EDAT- 2019/01/18 06:00
MHDA- 2019/01/18 06:01
PMCR- 2019/01/01
CRDT- 2019/01/18 06:00
PHST- 2018/05/11 00:00 [received]
PHST- 2018/10/02 00:00 [accepted]
PHST- 2019/01/18 06:00 [entrez]
PHST- 2019/01/18 06:00 [pubmed]
PHST- 2019/01/18 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.1055/a-0806-7006 [doi]
PST - ppublish
SO  - Endosc Int Open. 2019 Jan;7(1):E90-E98. doi: 10.1055/a-0806-7006. Epub 2019 Jan 
      15.