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Are KISS data representative of German intensive care units? Statistical issues
G Rücker1, R Schoop, J Beyersmann
1Institute of Medical Biometry and Medical Informatics, Freiburg, Germany. ruecker@imbi.uni-freiburg.de
Methods of Information in Medicine
|September 12, 2006
Summary
The German nosocomial infection surveillance system (KISS) underestimates infection rates in intensive care units (ICUs). A new study using random sampling and statistical modeling found actual infection rates are significantly higher than reported by KISS.
Area of Science:
- Infectious Disease Epidemiology
- Public Health Surveillance
Background:
- The German nosocomial infection surveillance system (KISS) is used as a benchmark for infection rates in intensive care units (ICUs).
- The representativeness and accuracy of KISS data for estimating true infection incidence rates remain unclear.
Purpose of the Study:
- To estimate unbiased incidence rates of nosocomial infections in German ICUs.
- To evaluate whether existing KISS data accurately reflect true infection incidence.
Main Methods:
- Utilized stratified random sampling of German ICUs, though participation challenges required adjustments for hospital size.
- Employed negative binomial regression to model incidence rates due to over-dispersion.
- Compared weighted incidence rates from the SIR study with standardized rate ratios (SRR) against KISS data.
Main Results:
- Observed 262 infections across 21,832 patient days in 50 ICUs.
- Found infections were more frequent in larger hospitals.
- The SIR study's incidence rates were, on average, 1.89 times higher than those reported by the KISS system.
Conclusions:
- Successfully implemented random sampling and statistical modeling for accurate infection rate estimation.
- Concluded that the KISS surveillance system tends to underestimate the actual incidence of nosocomial infections in German ICUs.
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