Interrater Reliability of a National Acute Myocardial Infarction Register

Overview

Journal Clin Epidemiol

Publisher Dove Medical Press

Specialty Public Health

Date 2016 Aug 31

PMID 27574467

Citations 11

Authors

Ragna Elise Store Govatsmark

Sylvi Sneeggen

Hanne Karlsaune

Stig Arild Slordahl

Kaare Harald Bonaa

Affiliations

Soon will be listed here.

Abstract

Background: Disease-specific registers may be used for measuring and improving healthcare and patient outcomes, and for disease surveillance and research, provided they contain valid and reliable data. The aim of this study was to assess the interrater reliability of all variables in a national myocardial infarction register.

Methods: We randomly selected 280 patients who had been enrolled from 14 hospitals to the Norwegian Myocardial Infarction Register during the year 2013. Experienced audit nurses, who were blinded to the data about the 280 patients already in the register, completed the Norwegian Myocardial Infarction paper forms for 240 patients by review of medical records. We then extracted all registered data on the same patients from the Norwegian Myocardial Infarction Register. To compare the interrater reliability between the register and the audit nurses, we calculated intraclass correlations coefficient for continuous variables, Cohen's kappa and Gwet's first agreement coefficient (AC1) for nominal variables, and quadratic weighted Cohen's kappa and Gwet's second AC for ordinal variables.

Results: We found excellent (AC1 >0.80) or good (AC1 0.61-0.80) agreement for most variables, including date and time variables, medical history, investigations and treatments during hospitalization, medication at discharge, and ST-segment elevation or non-ST-segment elevation acute myocardial infarction. However, only moderate agreement (AC1 0.41-0.60) was found for family history of coronary heart disease, diagnostic electrocardiography, and complications during hospitalization, whereas fair agreement (AC1 0.21-0.40) was found for acute myocardial infarction location. A high percentage of missing data was found for symptom onset, family history, body mass index, infarction location, and new Q-wave.

Conclusion: Most variables in Norwegian Myocardial Infarction Register had excellent or good reliability. However, some important variables had lower reliability than expected or had missing data. Precise definitions of data elements and proper training of data abstractors are necessary to ensure that clinical registries contain valid and reliable data.

Citing Articles

Short- and long-term outcomes of patients with acute myocardial infarction complicated by cardiac arrest: a nationwide cohort study 2013-22.

Jortveit J, Andersen G, Halvorsen S Eur Heart J Acute Cardiovasc Care. 2024; 13(12):828-837.

PMID: 39441985 PMC: 11666308. DOI: 10.1093/ehjacc/zuae121.

Excellent agreement of Norwegian trauma registry data compared to corresponding data in electronic patient records.

Naberezhneva N, Uleberg O, Dahlhaug M, Giil-Jensen V, Ringdal K, Roise O Scand J Trauma Resusc Emerg Med. 2023; 31(1):50.

PMID: 37752614 PMC: 10521548. DOI: 10.1186/s13049-023-01118-5.

Quality registry improves the data of chronic ulcers: Validation of Tampere Wound Registry.

Poyry A, Kimpimaki T, Kaartinen I, Salmi T Int Wound J. 2023; 20(9):3750-3759.

PMID: 37293796 PMC: 10588319. DOI: 10.1111/iwj.14270.

Time trends in incidence, treatment, and outcome in acute myocardial infarction in Norway 2013-19.

Jortveit J, Pripp A, Langorgen J, Halvorsen S Eur Heart J Open. 2022; 2(5):oeac052.

PMID: 36071696 PMC: 9442850. DOI: 10.1093/ehjopen/oeac052.

Reliability of estimating left ventricular ejection fraction in clinical routine: a validation study of the SWEDEHEART registry.

Lenell J, Lindahl B, Karlsson P, Batra G, Erlinge D, Jernberg T Clin Res Cardiol. 2022; 112(1):68-74.

PMID: 35581481 PMC: 9849182. DOI: 10.1007/s00392-022-02031-0.

References

Pajunen P, Koukkunen H, Ketonen M, Jerkkola T, Immonen-Raiha P, Karja-Koskenkari P . The validity of the Finnish Hospital Discharge Register and Causes of Death Register data on coronary heart disease. Eur J Cardiovasc Prev Rehabil. 2005; 12(2):132-7. DOI: 10.1097/00149831-200504000-00007. View

Madsen M, Davidsen M, Rasmussen S, Abildstrom S, Osler M . The validity of the diagnosis of acute myocardial infarction in routine statistics: a comparison of mortality and hospital discharge data with the Danish MONICA registry. J Clin Epidemiol. 2003; 56(2):124-30. DOI: 10.1016/s0895-4356(02)00591-7. View

. Rationale and design of the GRACE (Global Registry of Acute Coronary Events) Project: a multinational registry of patients hospitalized with acute coronary syndromes. Am Heart J. 2001; 141(2):190-9. DOI: 10.1067/mhj.2001.112404. View

Gwet K . Computing inter-rater reliability and its variance in the presence of high agreement. Br J Math Stat Psychol. 2008; 61(Pt 1):29-48. DOI: 10.1348/000711006X126600. View

Radovanovic D, Erne P . AMIS Plus: Swiss registry of acute coronary syndrome. Heart. 2010; 96(12):917-21. DOI: 10.1136/hrt.2009.192302. View

Arts D, de Keizer N, Scheffer G . Defining and improving data quality in medical registries: a literature review, case study, and generic framework. J Am Med Inform Assoc. 2002; 9(6):600-11. PMC: 349377. DOI: 10.1197/jamia.m1087. View

McNamara R . Cardiovascular registry research comes of age. Heart. 2010; 96(12):908-10. DOI: 10.1136/hrt.2010.198069. View

Bufalino V, Masoudi F, Stranne S, Horton K, Albert N, Beam C . The American Heart Association's recommendations for expanding the applications of existing and future clinical registries: a policy statement from the American Heart Association. Circulation. 2011; 123(19):2167-79. DOI: 10.1161/CIR.0b013e3182181529. View

Demlo L, Campbell P, Brown S . Reliability of information abstracted from patients' medical records. Med Care. 1978; 16(12):995-1005. DOI: 10.1097/00005650-197812000-00003. View

10.

Donner A, Eliasziw M . A goodness-of-fit approach to inference procedures for the kappa statistic: confidence interval construction, significance-testing and sample size estimation. Stat Med. 1992; 11(11):1511-9. DOI: 10.1002/sim.4780111109. View

11.

Messenger J, Ho K, Young C, Slattery L, Draoui J, Curtis J . The National Cardiovascular Data Registry (NCDR) Data Quality Brief: the NCDR Data Quality Program in 2012. J Am Coll Cardiol. 2012; 60(16):1484-8. DOI: 10.1016/j.jacc.2012.07.020. View

11.

Kurz D, Radovanovic D, Seifert B, Bernheim A, Roffi M, Pedrazzini G . Comparison of prasugrel and clopidogrel-treated patients with acute coronary syndrome undergoing percutaneous coronary intervention: A propensity score-matched analysis of the Acute Myocardial Infarction in Switzerland (AMIS)-Plus Registry. Eur Heart J Acute Cardiovasc Care. 2015; 5(1):13-22. DOI: 10.1177/2048872614566946. View

12.

Herrett E, Smeeth L, Walker L, Weston C . The Myocardial Ischaemia National Audit Project (MINAP). Heart. 2010; 96(16):1264-7. PMC: 3505836. DOI: 10.1136/hrt.2009.192328. View

13.

Sorensen H, Sabroe S, Olsen J . A framework for evaluation of secondary data sources for epidemiological research. Int J Epidemiol. 1996; 25(2):435-42. DOI: 10.1093/ije/25.2.435. View

14.

Landis J, Koch G . The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1):159-74. View

15.

Bhatt D, Drozda Jr J, Shahian D, Chan P, Fonarow G, Heidenreich P . ACC/AHA/STS Statement on the Future of Registries and the Performance Measurement Enterprise: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and The Society of Thoracic Surgeons. Ann Thorac Surg. 2015; 100(5):1926-41. DOI: 10.1016/j.athoracsur.2015.07.078. View

16.

Herrett E, Shah A, Boggon R, Denaxas S, Smeeth L, van Staa T . Completeness and diagnostic validity of recording acute myocardial infarction events in primary care, hospital care, disease registry, and national mortality records: cohort study. BMJ. 2013; 346:f2350. PMC: 3898411. DOI: 10.1136/bmj.f2350. View

17.

Feinstein A, Cicchetti D . High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol. 1990; 43(6):543-9. DOI: 10.1016/0895-4356(90)90158-l. View

18.

Cicchetti D, Feinstein A . High agreement but low kappa: II. Resolving the paradoxes. J Clin Epidemiol. 1990; 43(6):551-8. DOI: 10.1016/0895-4356(90)90159-m. View

19.

Mahonen M, Salomaa V, Brommels M, Molarius A, Miettinen H, Pyorala K . The validity of hospital discharge register data on coronary heart disease in Finland. Eur J Epidemiol. 1997; 13(4):403-15. DOI: 10.1023/a:1007306110822. View