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HIS 99-039 – HSR&D Study

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HIS 99-039
Improving the HIV/AIDS Immunology Case Registry
Samuel A. Bozzette MD PhD
VA San Diego Healthcare System, San Diego, CA
San Diego, CA
Funding Period: October 1999 - September 2002

BACKGROUND/RATIONALE:
This project is to continue to develop the basic QUERI effort to translate findings regarding appropriate regimens of care in light of inappropriate variation of actual practice. The means to support this effort is to develop the Immunology Case Registry (ICR) into a research database called the HIV Quality Enhancement Database (QED).

OBJECTIVE(S):
The group that has been working on the QUERI project will now extend their translation effort by integrating the SDR into a translation SDP, refocusing the SDR objective and building on their previous QUERI work.

METHODS:
This project utilizes an existing VA HIV registry to develop a research database to support quality improvement efforts in the area of HIV/AIDS care in the VA setting. Methods included data cleaning and standardization, evaluating completeness of data, performing internal logic checks and accuracy, augmenting ICR data using external sources, imputing missing values, and deriving a set of variables for other research.

FINDINGS/RESULTS:
In the course of developing the QED, we have identified a number of deficiencies in building the QED solely on ICR data. The deficiencies include incomplete case ascertainment, incomplete laboratory data, and a lack of data standardization. The staff is now taking steps to address these deficiencies through validation and augmentation with external data sources.

IMPACT:
Discovery of HIV-infected patients not included in the ICR. Clearer understanding of the influence of ARVs on the risk of cardiovascular diseases. QED data have been used by other researchers in the area of adherence to ARV medications and guidelines of care, and screening.

PUBLICATIONS:

Journal Articles

  1. Rabeneck L, Menke T, Simberkoff MS, Hartigan PM, Dickinson GM, Jensen PC, George WL, Goetz MB, Wray NP. Using the national registry of HIV-infected veterans in research: lessons for the development of disease registries. Journal of clinical epidemiology. 2001 Dec 1; 54(12):1195-203.
Conference Presentations

  1. Bozzette SA, Ake CF, Tam HK, Bowman C, Schepps A. Improving the HIV/AIDS Immunology Case Registry: Development of a research-standard database. Paper presented at: VA HIV/AIDS QUERI Meeting; 2003 Feb 14; San Diego, CA.
  2. Bowman C, Slipchenko T, Boomakanty U, Bozzette SA. Assessing completeness of the VA's Immunology Case Registry using a casefinding algorithm. Paper presented at: VA HSR&D National Meeting; 2003 Feb 1; Washington, DC.
  3. Tam HK, Slipchenko T, Schepps A, Bozzette SA. Epidemiology of HIV genotypic drug resistance testing in the VA. Paper presented at: VA HSR&D National Meeting; 2003 Feb 1; Washington, DC.


DRA: Health Systems
DRE: Epidemiology, Technology Development and Assessment
Keywords: HIV/AIDS, Research method
MeSH Terms: Observational Study, HIV

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