Lars Frost, Albert Marni Joensen, Ulla Dam-Schmidt, Ina Qvist, Margit Brinck, Axel Brandes, Ulla Davidsen, Ole Dyg Pedersen, Dorte Damgaard, Inge Mølgaard, Robert Bedsted, Anders Damgaard Møller Schlünsen, Miriam Grijota Chousa, Julie Andersen, Asger Roer Pedersen, Søren Paaske Johnsen, Nicklas Vinter
{"title":"丹麦心房颤动登记：基于从行政登记处获取的数据监测和支持医疗质量的多学科国家实用计划","authors":"Lars Frost, Albert Marni Joensen, Ulla Dam-Schmidt, Ina Qvist, Margit Brinck, Axel Brandes, Ulla Davidsen, Ole Dyg Pedersen, Dorte Damgaard, Inge Mølgaard, Robert Bedsted, Anders Damgaard Møller Schlünsen, Miriam Grijota Chousa, Julie Andersen, Asger Roer Pedersen, Søren Paaske Johnsen, Nicklas Vinter","doi":"10.2147/clep.s443473","DOIUrl":null,"url":null,"abstract":"<strong>Aim:</strong> The Danish Atrial Fibrillation (AF) Registry monitors and supports improvement of quality of care for all AF patients in Denmark. This report describes the registry’s administrative and organizational structure, data sources, data flow, data analyses, annual reporting, and feedback between the registry, clinicians, and the administrative system. We also report the selection process of the quality indicators and the temporal trends in results from 2017– 2021.<br/><strong>Methods and Results:</strong> The Danish AF Registry aims for complete registration and monitoring of care for all patients diagnosed with AF in Denmark. Administrative registries provide data on contacts to general practice, contacts to private cardiology practice, hospital contacts, medication prescriptions, updated vital status information, and biochemical test results. The Danish Stroke Registry provides information on stroke events. From 2017 to 2021, the proportion with a reported echocardiography among incident AF patients increased from 39.9% (95% CI: 39.3– 40.6) to 82.6% (95% CI: 82.1– 83.1). The initiation of oral anticoagulant therapy among patients with incident AF and a CHA<sub>2</sub>DS<sub>2</sub>-VASc score of ≥ 1 in men and ≥ 2 in women increased from 85.3% (95% CI: 84.6– 85.9) to 90.4% (95% CI: 89.9– 91.0). The 1-year and 2-year persistence increased from 85.2% (95% CI: 84.5– 85.9) to 88.7% (95% CI: 88.0– 89.3), and from 85.4% (95% CI: 84.7– 86.2) to 88.2% (95% CI: 87.5– 88.8), respectively. The 1-year risk of ischemic stroke among prevalent patients with AF decreased from 0.88% (95% CI: 0.83– 0.93) to 0.71% (95% CI: 0.66– 0.75). Variation in clinical performance between the five administrative Danish regions was reduced.<br/><strong>Conclusion:</strong> Continuous nationwide monitoring of quality indicators for AF originating from administrative registries is feasible and supportive of improvements of quality of care.<br/><br/><strong>Keywords:</strong> atrial fibrillation, quality indicators, quality of care<br/>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Danish Atrial Fibrillation Registry: A Multidisciplinary National Pragmatic Initiative for Monitoring and Supporting Quality of Care Based on Data Retrieved from Administrative Registries\",\"authors\":\"Lars Frost, Albert Marni Joensen, Ulla Dam-Schmidt, Ina Qvist, Margit Brinck, Axel Brandes, Ulla Davidsen, Ole Dyg Pedersen, Dorte Damgaard, Inge Mølgaard, Robert Bedsted, Anders Damgaard Møller Schlünsen, Miriam Grijota Chousa, Julie Andersen, Asger Roer Pedersen, Søren Paaske Johnsen, Nicklas Vinter\",\"doi\":\"10.2147/clep.s443473\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<strong>Aim:</strong> The Danish Atrial Fibrillation (AF) Registry monitors and supports improvement of quality of care for all AF patients in Denmark. This report describes the registry’s administrative and organizational structure, data sources, data flow, data analyses, annual reporting, and feedback between the registry, clinicians, and the administrative system. We also report the selection process of the quality indicators and the temporal trends in results from 2017– 2021.<br/><strong>Methods and Results:</strong> The Danish AF Registry aims for complete registration and monitoring of care for all patients diagnosed with AF in Denmark. Administrative registries provide data on contacts to general practice, contacts to private cardiology practice, hospital contacts, medication prescriptions, updated vital status information, and biochemical test results. The Danish Stroke Registry provides information on stroke events. From 2017 to 2021, the proportion with a reported echocardiography among incident AF patients increased from 39.9% (95% CI: 39.3– 40.6) to 82.6% (95% CI: 82.1– 83.1). The initiation of oral anticoagulant therapy among patients with incident AF and a CHA<sub>2</sub>DS<sub>2</sub>-VASc score of ≥ 1 in men and ≥ 2 in women increased from 85.3% (95% CI: 84.6– 85.9) to 90.4% (95% CI: 89.9– 91.0). The 1-year and 2-year persistence increased from 85.2% (95% CI: 84.5– 85.9) to 88.7% (95% CI: 88.0– 89.3), and from 85.4% (95% CI: 84.7– 86.2) to 88.2% (95% CI: 87.5– 88.8), respectively. The 1-year risk of ischemic stroke among prevalent patients with AF decreased from 0.88% (95% CI: 0.83– 0.93) to 0.71% (95% CI: 0.66– 0.75). Variation in clinical performance between the five administrative Danish regions was reduced.<br/><strong>Conclusion:</strong> Continuous nationwide monitoring of quality indicators for AF originating from administrative registries is feasible and supportive of improvements of quality of care.<br/><br/><strong>Keywords:</strong> atrial fibrillation, quality indicators, quality of care<br/>\",\"PeriodicalId\":10362,\"journal\":{\"name\":\"Clinical Epidemiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2023-12-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/clep.s443473\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/clep.s443473","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
The Danish Atrial Fibrillation Registry: A Multidisciplinary National Pragmatic Initiative for Monitoring and Supporting Quality of Care Based on Data Retrieved from Administrative Registries
Aim: The Danish Atrial Fibrillation (AF) Registry monitors and supports improvement of quality of care for all AF patients in Denmark. This report describes the registry’s administrative and organizational structure, data sources, data flow, data analyses, annual reporting, and feedback between the registry, clinicians, and the administrative system. We also report the selection process of the quality indicators and the temporal trends in results from 2017– 2021. Methods and Results: The Danish AF Registry aims for complete registration and monitoring of care for all patients diagnosed with AF in Denmark. Administrative registries provide data on contacts to general practice, contacts to private cardiology practice, hospital contacts, medication prescriptions, updated vital status information, and biochemical test results. The Danish Stroke Registry provides information on stroke events. From 2017 to 2021, the proportion with a reported echocardiography among incident AF patients increased from 39.9% (95% CI: 39.3– 40.6) to 82.6% (95% CI: 82.1– 83.1). The initiation of oral anticoagulant therapy among patients with incident AF and a CHA2DS2-VASc score of ≥ 1 in men and ≥ 2 in women increased from 85.3% (95% CI: 84.6– 85.9) to 90.4% (95% CI: 89.9– 91.0). The 1-year and 2-year persistence increased from 85.2% (95% CI: 84.5– 85.9) to 88.7% (95% CI: 88.0– 89.3), and from 85.4% (95% CI: 84.7– 86.2) to 88.2% (95% CI: 87.5– 88.8), respectively. The 1-year risk of ischemic stroke among prevalent patients with AF decreased from 0.88% (95% CI: 0.83– 0.93) to 0.71% (95% CI: 0.66– 0.75). Variation in clinical performance between the five administrative Danish regions was reduced. Conclusion: Continuous nationwide monitoring of quality indicators for AF originating from administrative registries is feasible and supportive of improvements of quality of care.
Keywords: atrial fibrillation, quality indicators, quality of care
期刊介绍：
Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment.
Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews.
Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews.
When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes.
The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.
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