Dataset Information

Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods.

ABSTRACT:

Background

there is no established method to identify care-home residents in routine healthcare datasets. Methods matching patient's addresses to known care-home addresses have been proposed in the UK, but few have been formally evaluated.

Study design

prospective diagnostic test accuracy study.

Methods

four independent samples of 5,000 addresses from Community Health Index (CHI) population registers were sampled for two NHS Scotland Health Boards on 1 April 2017, with one sample of adults aged ?65 years and one of all residents. To derive the reference standard, all 20,000 addresses were manually adjudicated as 'care-home address' or not. The performance of five methods (NHS Scotland assigned CHI Institution Flag, exact address matching, postcode matching, Phonics and Markov) was evaluated compared to the reference standard.

Results

the CHI Institution Flag had a high PPV 97-99% in all four test sets, but poorer sensitivity 55-89%. Exact address matching failed in every case. Postcode matching had higher sensitivity than the CHI flag 78-90%, but worse PPV 77-85%. Area under the receiver operating curve values for Phonics and Markov scores were 0.86-0.95 and 0.93-0.98, respectively. Phonics score with cut-off ?13 had PPV 92-97% with sensitivity 72-87%. Markov PPVs were 90-95% with sensitivity 69-90% with cut-off ?29.6.

Conclusions

more complex address matching methods greatly improve identification compared to the existing NHS Scotland flag or postcode matching, although no method achieved both sensitivity and positive predictive value > 95%. Choice of method and cut-offs will be determined by the specific needs of researchers and practitioners.

SUBMITTER: Burton JK

PROVIDER: S-EPMC6322499 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods.

Burton Jennifer K JK Marwick Charis A CA Galloway James J Hall Christopher C Nind Thomas T Reynish Emma L EL Guthrie Bruce B

Age and ageing 20190101 1

<h4>Background</h4>there is no established method to identify care-home residents in routine healthcare datasets. Methods matching patient's addresses to known care-home addresses have been proposed in the UK, but few have been formally evaluated.<h4>Study design</h4>prospective diagnostic test accuracy study.<h4>Methods</h4>four independent samples of 5,000 addresses from Community Health Index (CHI) population registers were sampled for two NHS Scotland Health Boards on 1 April 2017, with one ...[more]

PMID: 30124764

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Project description:BackgroundCochrane reviews are one of the best known and most trusted sources of evidence-based information in health care. While steps have been taken to make Cochrane intervention reviews accessible to a diverse readership, little is known about the accessibility of the newcomer to the Cochrane library: diagnostic test accuracy reviews (DTARs). The current qualitative study explored how healthcare decision makers, who varied in their knowledge and experience with test accuracy research and systematic reviews, read and made sense of DTARs.MethodsA purposive sample of clinicians, researchers and policy makers (n = 21) took part in a series of think-aloud interviews, using as interview material the first three DTARs published in the Cochrane library. Thematic qualitative analysis of the transcripts was carried out to identify patterns in participants' 'reading' and interpretation of the reviews and the difficulties they encountered.ResultsParticipants unfamiliar with the design and methodology of DTARs found the reviews largely inaccessible and experienced a range of difficulties stemming mainly from the mismatch between background knowledge and level of explanation provided in the text. Experience with systematic reviews of interventions did not guarantee better understanding and, in some cases, led to confusion and misinterpretation. These difficulties were further exacerbated by poor layout and presentation, which affected even those with relatively good knowledge of DTARs and had a negative impact not only on their understanding of the reviews but also on their motivation to engage with the text. Comparison between the readings of the three reviews showed that more accessible presentation, such as presenting the results as natural frequencies, significantly increased participants' understanding.ConclusionsThe study demonstrates that authors and editors should pay more attention to the presentation as well as the content of Cochrane DTARs, especially if the reports are aimed at readers with various levels of background knowledge and experience. It also raises the question as to the anticipated target audience of the reports and suggests that different groups of healthcare decision-makers may require different modes of presentation.

Dataset Information

Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods.

Background

Study design

Methods

Results

Conclusions

Publications

Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods.

Similar Datasets

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