Assessing Accuracy and Completeness of Research Data
Assessing the accuracy and completeness of data is an important component of conducting research. Moreover, clinical quality and efficiency studies may be biased by inaccurate or incomplete data derived from electronic medical record systems. VA benefits from one of the most highly developed health information systems in the world, which includes the Immunology Case Registry (ICR) that was designed to monitor costs and quality of HIV care, and the Decision Support System (DSS) that was developed to monitor utilization and costs of veterans in care. This study compared ICR and DSS datasets, which share overlapping laboratory data from the same VA electronic record system. Investigators focused on specific tests given to 17,463 HIV-positive veterans with an inpatient or outpatient visit in FY02, who participated in the Veterans Aging Cohort Study Virtual Cohort and had data in both the ICR and DSS datasets. Tests included: hemoglobin, CD4+ lymphocyte counts (CD4), HIV RNA viral load (VL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glycosylated hemoglobin (HBA1c), creatinine, and white blood count (WBC).
Findings show that six of the laboratory tests demonstrated remarkably similar amounts of overlap (68% to 72%) between the two datasets, showing that ICR and DSS are both good sources of data for these tests. However, CD4, VL, and HBA1c, demonstrated much lower proportions of overlap (between 20% and 31%). These findings indicate that validation of laboratory data should be conducted prior to its use in quality and efficiency projects. Authors suggest that when two databases are not available for comparison, other methods of validation should be implemented.
McGinnis K, Skanderson M, Levin F, Brandt C, Erdos J, and Justice A. Comparison of two VA laboratory data repositories indicates that missing data vary despite originating from the same source. Medical Care 2009 Jan;47(1):121-24.
Drs. McGinnis and Skanderson are part of HSR&D’s Center for Health Equity Research and Promotion in Pittsburgh. All other authors are part of the VA Connecticut Healthcare System.