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Adherence to Methodological Standards in Research Using the National Inpatient Sample
Rohan Khera1, Suveen Angraal2, Tyler Couch1
1Division of Cardiology, University of Texas Southwestern Medical Center, Dallas.
JAMA
|November 29, 2017
Summary
Most studies using the National Inpatient Sample (NIS) database did not follow required research practices. This highlights a need for improved data analysis and interpretation strategies for public health research.
Area of Science:
- Health Services Research
- Public Health Data Analytics
- Biostatistics
Background:
- Publicly available datasets like the National Inpatient Sample (NIS) offer valuable research opportunities.
- However, their unique structure necessitates specific analytical approaches for accurate interpretation.
- Adherence to recommended research practices is crucial for the validity of findings derived from such data.
Purpose of the Study:
- To evaluate the adherence to essential research practices among studies utilizing the National Inpatient Sample (NIS) database.
- To identify common deviations from recommended methodologies in NIS research.
- To inform strategies for enhancing the quality of research using large public health datasets.
Main Methods:
- An observational study systematically reviewed 120 publications from January 2015 to December 2016 that used the NIS.
- Studies were assessed for adherence to 7 key research practices recommended by the Agency for Healthcare Research and Quality (AHRQ).
- Practices covered data interpretation, research design, and data analysis, including accounting for survey design and data structure changes.
Main Results:
- A significant majority of reviewed studies (85%) failed to adhere to at least one required practice.
- 62% of studies deviated from two or more essential research practices.
- Common issues included misinterpreting hospitalizations as unique patients, inappropriate state-level analyses, and failing to account for the NIS complex survey design and data structure changes.
Conclusions:
- The majority of recent publications using the NIS database did not comply with required research practices.
- There is a critical need to develop and implement strategies to improve the quality and rigor of research conducted with the NIS.
- Findings suggest potential similar issues in the utilization of other large, publicly available health datasets, warranting further investigation.
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