Data quality assessment in the SWEDEHEART registry: Insights from serial audits on completeness and accuracy

Registry data used to monitor clinical care need to be reliable, and the process for assuring data quality transparent. Here the auditing process of the Swedish quality registry for cardiac disease, SWEDEHEART, is described.

SWEDEHEART audits have been performed at 4 time-points in 2011 to 2018, with data quality audited in the 3 largest subregistries covering acute coronary syndromes (ACS), percutaneous coronary interventions (PCI), and cardiac rehabilitation (CR). Data is audited against electronic medical records by 4 controllers, centrally coordinated by a project leader. During the 2011 audit 13/71 (18.3%) of ACS-admitting hospitals and 8/28 (28.6%) of coronary catheterization labs reporting to the registry were audited. During the 2017 to 2018 audit all reporting sites (100.0%) were audited: 72 hospitals, 30 catheterization labs, and 75 CR centres, with more than 200,000 data points controlled.

Overall data completeness in the 2017 to 2018 audit was as follows: SWEDEHEART-ACS 99.1%, SWEDEHEART-PCI 99.2%, and SWEDEHEART-CR 94.5%. The accuracy of registry data compared to electronic medical records was >95.0% for all subregistries at all 4 audits (P for trend < .0001), in 2017 to 2018 as follows: SWEDEHEART-ACS 97.5%, SWEDEHEART-PCI 98.4%, and SWEDEHEART-CR 95.8%. Data most often incomplete or inconsistent were data on time points, self-reported data, and data reliant on complex definitions.

The SWEDEHEART registry is a highly complete and accurate source of patient characteristics and processes of care, that can be reliably used for quality improvement such as monitoring quality of care, to compare hospitals at site- and national level, include in international comparisons, and for conducting high-quality registry-based research.