2015-2019年中国居民心脑血管事件报告数据质量分析

颜流霞 陈晓荣 覃玉 龚巍巍 史卫卫 李茜 何予晋 吴静

颜流霞, 陈晓荣, 覃玉, 龚巍巍, 史卫卫, 李茜, 何予晋, 吴静. 2015-2019年中国居民心脑血管事件报告数据质量分析[J]. 疾病监测. doi: 10.3784/jbjc.202101130020
引用本文: 颜流霞, 陈晓荣, 覃玉, 龚巍巍, 史卫卫, 李茜, 何予晋, 吴静. 2015-2019年中国居民心脑血管事件报告数据质量分析[J]. 疾病监测. doi: 10.3784/jbjc.202101130020
Yan Liuxia, Chen Xiaorong, Qin Yu, Gong Weiwei, Shi Weiwei, Li Qian, He Yujin, Jing Wu. Data quality of acute stroke and myocardial infarction events registry in China, 2015–2019[J]. Disease Surveillance. doi: 10.3784/jbjc.202101130020
Citation: Yan Liuxia, Chen Xiaorong, Qin Yu, Gong Weiwei, Shi Weiwei, Li Qian, He Yujin, Jing Wu. Data quality of acute stroke and myocardial infarction events registry in China, 2015–2019[J]. Disease Surveillance. doi: 10.3784/jbjc.202101130020

2015-2019年中国居民心脑血管事件报告数据质量分析

doi: 10.3784/jbjc.202101130020
基金项目: 国家重点研发计划(No. 2018YFC1311703)
详细信息
    作者简介:

    颜流霞,女,浙江省温岭市人,硕士,副研究员,从事心脑血管疾病防控与评估,Email:yanliuxia@ncncd.chinacdc.cn

    陈晓荣,女,山东省济宁市人,博士,研究员,从事营养运动与心脑血管疾病防控,Email:chenxiaorong@ncncd.chinacdc.cn

    通讯作者:

    吴静,Tel:010–83154663,Email:wujing@ncncd.chinacdc.cn

  • 颜流霞和陈晓荣同为第一作者
  • 中图分类号: R211; R54

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

Funds: This study was supported by National Key Research and Development Project of China (No. 2018YFC1311703)
  • 摘要:   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2 184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2 062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75.1%~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。
    1)  颜流霞和陈晓荣同为第一作者
  • 表  1  2015-2019年心脑血管事件报告质量复核数量

    Table  1.   Verified stroke and acute MI events, 2015–2019

    年份脑卒中急性心肌梗死
    应复核的
    报告卡数量
    查找到并复核原始
    资料的数量
    复核率
    (%)
    应复核的
    报告卡数量
    查找到并复核原始
    资料的数量
    复核率
    (%)
    201545043897.3312111494.21
    201645043396.2215514090.32
    201745043095.5615513788.39
    201845044398.44157157100
    201945044097.7815215199.34
    合计2 250 2 184 97.0774069994.46
      注:受新冠肺炎疫情影响,1家医疗机构未能按预期完成现场复核,未纳入分析
    下载: 导出CSV

    表  2  2015-2019年病案记录和临床辅助检查采集情况

    Table  2.   Medical records collected for stroke and acute MI verification, 2015–2019

    年份脑卒中急性心肌梗死
    病案首页出/入院记录CTMRI病案首页出/入院记录心电图血清酶
    采集数采集比(%)采集数采集比(%)采集数采集比(%)采集数采集比(%)采集数采集比(%)采集数采集比(%)采集数采集比(%)采集数采集比(%)
    201538988.8143810038487.6721348.6310188.6011410011399.1210692.98
    201638789.3843299.7737887.3019344.5713092.8614010012891.4312790.71
    201738890.2342899.5334880.9322953.2612591.2413710012994.1612591.24
    201844299.7744299.7736081.2624354.85157100.0015710015095.5414793.63
    201944010044010036783.4120646.8215099.3415110013790.7313690.07
    合计2 04693.682 18099.821 83884.161 08449.6366394.8569910065793.9964191.70
      注:CT. 计算机X线断层扫描;MRI. 磁共振成像
    下载: 导出CSV

    表  3  2015-2019年急性心脑血管事件报告完整性

    Table  3.   Completeness of key variables of stroke and acute MI event reports, 2015–2019

    年份脑卒中急性心肌梗死
    身份证号(%)诊断名称(%)发病时间(%)诊断依据(症状+
    CT/MRI)(%)
    身份证号(%)诊断名称(%)发病时间(%)诊断依据(1+1a
    (%)
    2015100.00100.00100.0083.3399.10100.00100.0069.30
    2016100.00100.00100.0085.22100.00100.00100.0071.43
    2017100.00100.00100.0080.93100.00100.00100.0079.56
    2018100.00100.00100.0079.91100.00100.00100.0089.17
    2019 99.77100.00100.0084.32100.00100.00100.0084.77
    合计 99.95100.00100.0082.74100.00100.00100.0079.54
      注:a. 1+1是指按照急性心肌梗死全球定义,心脏生物标志物(最好是肌钙蛋白)增高或增高后降低,至少有1次数值超过参考值上限的99%,并有以下至少一项心肌缺血的证据即可被诊断为急性心肌梗死:缺血症状;新的心肌缺血心电图变化;心电图出现病理性Q波;影像学证据显示新的活力心肌丧失或区域性心壁运动异常9
    下载: 导出CSV

    表  4  2015-2019年急性心脑血管事件报告复核变量准确性(%)

    Table  4.   Accuracy of the key variables of stroke and acute MI event reports, 2015–2019

    年份脑卒中急性心肌梗死
    身份证号(%)a报告的发病时间与病史记录日期的差值身份证号(%)a报告的发病时间与病史记录日期的差值
    一致(%)≤28 d(%)b>28 d(%)b一致(%)≤28 d(%)b>28 d(%)b
    201592.4777.1716.895.9494.7466.6725.447.89
    201695.1577.1717.785.0893.5775.0020.714.29
    201793.9577.9119.532.5694.8972.2620.447.30
    201897.7480.1417.612.2694.9071.9722.935.10
    201996.3683.6415.231.1498.6887.4210.601.99
    合计95.1579.2117.393.4095.4275.1019.745.16
      注:a. 按照中华人民共和国公民身份号码编码规则,对报告的18位身份证号准确性进行校验。b. 基于入院记录/出院记录,核查报告卡发病时间的准确性。按照世界卫生组织“多国心血管病决定因素及其趋势的监测”研究技术手册要求,≤28 d再次发生的事件算一次事件,>28 d算二次事件。中国居民心脑血管事件报告也参考以上规则界定报告事件
    下载: 导出CSV

    表  5  2015-2019年急性心脑血管事件报告阳性预测值

    Table  5.   Positive predictive value of stroke and acute MI event reports, 2015–2019

    年份脑卒中急性心肌梗死
    假阳性真阳性阳性预测值(%)假阳性真阳性阳性预测值(%)
    20152841093.61311197.37
    20163040393.071013092.86
    20172340794.65413397.08
    20182441994.58415397.45
    20191742396.141014193.38
    合计1222 06294.413166895.57
    下载: 导出CSV
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  • 收稿日期:  2021-01-13
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