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The Western Denmark Cardiac Computed Tomography Registry: a review and validation study

Authors Nielsen L, Nørgaard B, Tilsted H, Sand NP, Jensen JM, Bøttcher M, Diederichsen A, Lambrechtsen J, Deibjerg Kristensen L, Mickley H, Munkholm H, Gøtzsche O, Lyhne Knudsen L, Bøtker HE, Pedersen L, Schmidt M

Received 4 September 2014

Accepted for publication 13 October 2014

Published 31 December 2014 Volume 2015:7 Pages 53—64


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Henrik Toft Sørensen

Lene Hüche Nielsen,1 Bjarne Linde Nørgaard,2 Hans Henrik Tilsted,3 Niels Peter Sand,4 Jesper Møller Jensen,2 Morten Bøttcher,5 Axel Diederichsen,6 Jess Lambrechtsen,7 Lone Deibjerg Kristensen,8 Hans Mickley,6 Henrik Munkholm,1 Ole Gøtzsche,2 Lars Lyhne Knudsen,5 Hans Erik Bøtker,2 Lars Pedersen,9 Morten Schmidt,2,9

1Department of Cardiology, Lillbaelt Hospital-Vejle, Vejle, Denmark; 2Department of Cardiology Aarhus University Hospital-Skejby, Aarhus, Denmark; 3Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; 4Department of Cardiology, Hospital of Southwestern Denmark-Esbjerg, Esbjerg, Denmark; 5Department of Cardiology, Regional Hospital Herning, Herning, Denmark; 6Department of Cardiology, Odense University Hospital, Odense, Denmark; 7Department of Cardiology, Odense University Hospital-Svendborg, Svendborg, Denmark; 8Department of Cardiology, Regional Hospital Silkeborg, Silkeborg, Denmark; 9Department of Clinical Epidemiology, Aarhus University Hosptial, Aarhus, Denmark

Background: As a subregistry to the Western Denmark Heart Registry (WDHR), the Western Denmark Cardiac Computed Tomography Registry (WDHR-CCTR) is a clinical database established in 2008 to monitor and improve the quality of cardiac computed tomography (CT) in Western Denmark.
Objective: We examined the content, data quality, and research potential of the WDHR-CCTR.
Methods: We retrieved 2008–2012 data to examine the 1) content; 2) completeness of procedure registration using the Danish National Patient Registry as reference; 3) completeness of variable registration comparing observed vs expected numbers; and 4) positive predictive values as well as negative predictive values of 19 main patient and procedure variables.
Results: By December 31, 2012, almost 22,000 cardiac CTs with up to 40 variables for each procedure have been registered. Of these, 87% were coronary CT angiography performed in patients with symptoms indicative of coronary artery disease. Compared with the Danish National Patient Registry, the overall procedure completeness was 72%. However, an additional medical record review of 282 patients registered in the Danish National Patient Registry, but not in the WDHR-CCTR, showed that coronary CT angiographies accounted for only 23% of all nonregistered cardiac CTs, indicating >90% completeness of coronary CT angiographies in the WDHR-CCTR. The completeness of individual variables varied substantially (range: 0%–100%), but was >85% for more than 70% of all variables. Using medical record review of 250 randomly selected patients as reference standard, the positive predictive value for the 19 variables ranged from 89% to 100% (overall 97%), whereas the negative predictive value ranged from 97% to 100% (overall 99%). Stratification by center status showed consistently high positive and negative predictive values for both university (96%/99%) and nonuniversity centers (97%/99%).
Conclusion: WDHR-CCTR provides ongoing prospective registration of all cardiac CTs performed in Western Denmark since 2008. Overall, the registry data have a high degree of completeness and validity, making it a valuable tool for clinical epidemiological research.

Keywords: coronary computed tomography angiography, database, epidemiology, registries

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