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The exposure and outcome information in a cohort study were identified retrospectively by using administrative datasets and by reviewing patient charts, but these are sometimes frail.
16, 17, 20– 27 Four prospective studies relied on identification of potential ADRs by physician reporting, 17, 21, 26, 28 while the remaining two studies were retrospective cohort studies using administrative datasets and identified potential ADRs retrospectively from the medical record.
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Nevertheless, there are known limitations to using administrative datasets including under-enumeration of haemorrhage, transfusion and other adverse outcomes as well as difficulties in establishing temporality of events.
In Australia, there has been keen interest in using administrative datasets to examine hospital performance [ 26- 28] with surgeons, administrators and patients having endorsed independent review of surgical care [ 29].
We examined age-based associations between influenza medical visits and population-wide hospitalization/mortality due to pneumonia & influenza (P&I) using administrative datasets in British Columbia, Canada.
When considering categorization of emergency department injury visits, investigators using administrative datasets should select the schema that most closely aligns with their aims (i.e., injury severity versus resource utilization), or use a combined approach that incorporates both measures.
Drawbacks in determining the Charlson index by using administrative datasets have been reported previously.
It has been suggested that using clinical datasets for risk model development is more appropriate than using administrative datasets.
Using administrative datasets means that detailed clinical information that could be used to stratify the men into risk categories or describe their PSA testing history was not available.
While misclassification is a threat to the validity of a study, it is not a sufficient reason to dismiss observational research using administrative datasets.
Therefore, it shares drawbacks of using administrative datasets in evaluating quality such as inability to specify clinical definitions for risk factors (e.g., forced reliance on ICD-9 codes), and limited ability to distinguish between complications of care and pre-existing conditions.
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