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IMA Journal of Management Mathematics Advance Access originally published online on November 13, 2008
IMA Journal of Management Mathematics 2009 20(4):385-393; doi:10.1093/imaman/dpn034
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© The authors 2008. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

This article appears in the following IMA Journal of Management Mathematics issue: Special Issue Applying Mathematics to Problems in Health Care [View the issue table of contents]

Exploring potential consequences on mortality estimates of errors in clinical databases

Christina Pagel{dagger} and Steve Gallivan{ddagger}

Clinical Operational Research Unit, University College London, Gower Street, London, WC1E 6BT, UK

{dagger} Corresponding author. Email: c.pagel{at}ucl.ac.uk

{ddagger} Email: steve.gallivan{at}ucl.ac.uk

Received on 1 May 2007. Accepted on 1 October 2007.

Much time and energy are spent collecting and recording clinical data relating to outcomes, either within a single hospital or at a national level, in order to assess performance. Analysis of these data, particularly with respect to mortality rates, is a key part of clinical governance. However, most analyses are based on the assumption that data are accurate whereas, given the complexity of the data-gathering procedures, errors are not uncommon. Thus, it is useful to have insight into potential problems that might arise from analyses based on incomplete or erroneous data. We have developed a mathematical model that can be used to assess the effects of errors on estimates of mortality rates derived from clinical databases. Using simple assumptions about the nature of such errors, we have conducted thought experiments to investigate their potential impact. We show that there are plausible circumstances in which errors could cause systematic biases potentially leading to serious misinterpretation of clinical performance.

Keywords: clinical databases; errors; mortality rates


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