The Victorian Emergency Minimum Dataset showed complete concordance with medical records for eight items in only 33% of emergency presentations for acute cardiovascular conditions and chest pain.
Observational (n=310)
No
What is the level of agreement between the Victorian Emergency Minimum Dataset (VEMD) and medical records for emergency presentations of acute cardiovascular conditions and unspecified chest pain?
There is significant variation in the accuracy of VEMD coding compared to medical records for acute cardiovascular presentations, suggesting researchers may need to combine codes for reliability.
OBJECTIVE: The Victorian Emergency Minimum Dataset (VEMD) collects administrative and clinical data for all presentations to Victorian public ED. The present study aimed to examine the level of agreement between the VEMD data and the medical record for a sample of patients coded as having acute cardiovascular conditions (acute coronary syndrome, stroke and transient ischaemic attack TIA) and unspecified chest pain in the VEMD. METHODS: Six months of data provided to the VEMD from a large metropolitan hospital was obtained, and a random sample of 10% of cases (n = 310) were selected for review. Data for eight VEMD items were compared for concordance to data recorded in the ED medical record. RESULTS: Complete concordance between the VEMD and medical records for all eight items was observed only for 101 (33%) presentations. Overall, the least concordant variables were those with a high number of coding options: usual type of accommodation (76%), referral pattern (84%) and primary diagnosis (85%). The concordance of the VEMD primary diagnosis varied when examined as individual codes (range 75%-100%) and when combined (acute coronary syndrome = 94%, stroke or TIA = 85% and chest pain unspecified = 75%). The level of agreement for some items improved when VEMD codings were combined. CONCLUSION: When compared to the medical record, our data suggest there is likely variation in the accuracy of some VEMD items, and suggests a larger prospective validation of the VEMD is warranted. For researchers using existing VEMD data, combining of some codes may be necessary.
Bray et al. (Fri,) conducted a observational in Acute cardiovascular conditions and unspecified chest pain (n=310). Victorian Emergency Minimum Dataset (VEMD) vs. ED medical records was evaluated on Complete concordance between the VEMD and medical records for all eight items. The Victorian Emergency Minimum Dataset showed complete concordance with medical records for eight items in only 33% of emergency presentations for acute cardiovascular conditions and chest pain.