Evidence of data quality in trauma registries: A systematic review

Abstract

Background: Trauma registries are clinical databases designed for quality improvement activities and research and have made important contributions to the improvements in trauma care during the last few decades. The effectiveness of trauma registries in improving patient outcomes depends on data quality (DQ). However, our understanding of DQ in trauma registries is limited. The objective of this study was to review evidence of the completeness, accuracy, precision, correctness, consistency, and timeliness of data in trauma registries.

Methods: A systematic review using MEDLINE, EMBASE, Web of Science, CINAHL, and The Cochrane Library was performed including studies evaluating trauma registry DQ based on completeness, accuracy, precision, correctness, consistency, or timeliness. We also searched MEDLINE to identify regional, national, and international trauma registries whose data were used 10 times or more in original studies in the last 10 years; administrators of those registries were contacted to obtain their latest DQ report. Two authors abstracted the data independently.

Results: The search retrieved 7,495 distinct published articles, of which 10 were eligible for inclusion. We also reviewed DQ reports from five provincial and international trauma registries. Evaluation was mostly based on completeness with values between 46.8% (mechanism of injury) and 100% (age and sex). Accuracy was between 81.0% (operating room time) and 99.8% (sex). No evidence of data precision or timeliness was available. Correctness varied from 47.6% (Injury Severity Score [ISS]) to 83.2% (Glasgow Coma Scale [GCS] score) and consistency between variables from 87.5% (International Classification of Disease--9th Rev.--Clinical Modification [ICD-9-CM]/Abbreviated Injury Scale [AIS]) to 99.6% (procedure time).

Conclusion: In the few studies we identified, DQ evaluation in trauma registries was mostly based on completeness. There is a need to develop a standardized and reproducible method to evaluate DQ in trauma registries. Determinants of DQ and the impact of DQ on trauma registry analyses such as benchmarking with quality indicators should also be explored.