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Missing hospital records: a confounding variable in retrospective studies.

M Westgren, M Divon, J Greenspoon

American Journal of Obstetrics and Gynecology

|August 1, 1986

Summary

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Retrospective chart reviews may miss complex cases, impacting infant health study accuracy. Researchers recommend reporting missing data in retrospective studies to ensure reliable findings on very low birth weight infants.

Area of Science:

Neonatalogy
Medical Informatics
Biostatistics

Background:

Retrospective chart reviews are common in medical research but can suffer from missing data.
The completeness of hospital records can influence study outcomes, particularly for vulnerable populations like very low birth weight infants.

Purpose of the Study:

To compare the outcomes of very low birth weight breech infants based on data collection methods (prospective vs. retrospective).
To investigate the impact of missing hospital records on study findings.

Main Methods:

Prospective data sampling during hospital stays in 1979-1980 and 1983-1984.
Retrospective record search for 1981-1982 using the institution's standard system.
Comparison of infant demographics and mortality rates across the different data collection periods.

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Main Results:

The retrospective period (1981-1982) had a significantly lower apparent frequency of very low birth weight infants (1.32/1000 live births) compared to prospective periods (1.89-1.90/1000 live births).
Infants in the retrospective group had higher mean gestational age and birth weight, and lower neonatal mortality (28.2%) compared to prospective groups (74.1% and 57.1%).
A higher proportion (25%) of hospital records were missing in the retrospective study period.

Conclusions:

Complex clinical cases, such as those involving very low birth weight breech infants, are more likely to have missing records in retrospective chart reviews.
The completeness of data collection significantly impacts study results and should be carefully considered.
Future retrospective observational studies should report the number of missing charts to ensure transparency and data integrity.