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Accuracy of routine data on paediatric cataract in the UK compared to active surveillance: lessons from the IOLu2
Ameenat Lola Solebo1, Isabelle Russell-Eggitt, Jugnoo Sangheeta Rahi
1MRC Centre of Epidemiology for Child Health, Institute of Child Health University College London, London, UK.
Insights
Active surveillance identified more cataract surgeries in children under 2 years old than routine NHS data collection. This highlights inaccuracies in current reporting systems for pediatric eye procedures.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Health Informatics
Background:
- The UK and Ireland study of primary intraocular lens (IOL) implantation in children under 2 years old aimed to assess data collection methods.
- Active surveillance was implemented to identify all children under 2 years undergoing cataract surgery.
- The study compared active surveillance findings with routine National Health Service (NHS) data capture for surgical episodes.
Purpose of the Study:
- To evaluate the completeness and accuracy of routine NHS data for pediatric cataract surgery.
- To compare case ascertainment rates between active surveillance and routine NHS data collection.
- To identify weaknesses in the routine data collection of surgical episodes in infants.
Main Methods:
- Comparison of NHS Information Centre data on lens extractions in children under 2 years with active surveillance case reports.
- Active surveillance was conducted by the British Congenital Cataract Interest Group (BCCIG).
Main Results:
- In 2009-2010, NHS databases recorded 483 lens extractions in children under 2 years for lens-related disease.
- Active surveillance by BCCIG identified 490 cases of lens extraction for congenital/infantile cataract in the same period.
- Disparities were observed in the coding of surgical procedures within the NHS data.
Conclusions:
- Reporting of cataract surgery in children under 2 years to NHS information centres is incomplete and inaccurate.
- Hospital Activity Statistics could be a viable monitoring tool if coding accuracy improves.
- Active surveillance clinical networks provide a more reliable method for case ascertainment in research settings.
Background/Aims:
As part of the UK and Ireland study of primary IOL implantation in children under 2, active surveillance has been undertaken to identify children aged <2 years undergoing surgery for cataract. Ascertainment through active surveillance has been compared to the routine NHS capture of episodes of surgery, in order to identify any weaknesses in routine data collection.
Methods:
NHS information centre data on the number of children undergoing lens extraction in the first two years of life were compared to the number of cases reported through active surveillance.
Results:
In 2009 and 2010 in the United Kingdom, 483 episodes of lens extraction in children aged <2 years with lens-related disease were reported to NHS databases, compared to 490 cases of lens extraction for congenital / infantile cataract ascertained by the BCCIG through active surveillance. There was also disparity in the coding of procedures.
Conclusions:
There is evidence of incomplete and inaccurate reporting to NHS information centres of cataract surgery in children aged <2 years. If the accuracy of the coding could be improved then the Hospital Activity Statistics offer a reasonable approach to monitoring trends in the NHS. Nevertheless, active surveillance clinical networks remain a more robust method of case ascertainment for research.
