Procedure-level data linkage to drive improvement in case ascertainment for the Australian Breast Device Registry

Background: The Australian Breast Device Registry (ABDR) monitors breast device safety by collecting procedure data from clinicians across Australian jurisdictions. Ensuring high case ascertainment, including implant insertion and revision, is essential. By linking with an administrative dataset, the ABDR can identify hospital and procedure-level data gaps to assess case ascertainment more effectively, supplementing previous efforts using breast device sales data. The aim of this project was to link ABDR data with the Victorian Admitted Episodes Dataset (VAED) to determine total and procedure-level case ascertainment and to provide feedback to participating sites regarding their data capture to support quality improvement. Method: The ABDR applied to the Centre for Victorian Data Linkage (CVDL) to administer the data linkage, employing a series of Australian Classification of Health Intervention (ACHI) procedure codes. Then, using this data, the ABDR produced site-specific case ascertainment reports. Results: The CVDL was able to match ABDR breast device-related procedures to the VAED dataset, demonstrating an overall 79% case ascertainment. Tissue expander removal and implant insertion procedures were most commonly captured (89%) and those least captured were tissue expander revision and removal or replacement procedures (59%). Customised site-specific reports were developed and distributed, comprising a series of benchmarked line graphs to track site procedure ascertainment over 6 years. Conclusion: Data linkage informed ABDR total and procedure-level case ascertainment in Victorian public and private hospitals. Reporting back to hospitals, their individual case ascertainment is integral to addressing gaps in case reporting and improving overall registry data capture and completeness. The registry proposes to complete data linkage annually in Victoria to monitor improvements in case reporting, and explore using data linkage in other health jurisdictions in the future. Implications for health information management practice: Data completeness is critical to data quality and use for clinical decision-making. Third-party data verification processes are a useful activity to enhance the quality of health service-contributed data to registries.