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Validation of Swedevox registry of continuous positive airway pressure (CPAP), long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT)

  1. Magnus Ekström1⇑,
  2. Dirk Albrecht2,
  3. Susanne Andersson3,
  4. Ludger Grote4,5,
  5. Birgitta Kärrsten Rundström4,
  6. Andreas Palm6,7,
  7. Jenny Theorell-Haglöw6,
  8. Josefin Wahlberg8 and
  9. Bengt Midgren1
  1. 1Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden
  2. 2Department of Respiratory Medicine, Sunderby Hospital, Luleå, Sweden
  3. 3Respiratory unit, Department of Medicine, Hallands Hospital, Halmstad, Sweden
  4. 4Sleep Disorders Centre, Pulmonary Department, Sahlgrenska University Hospital, Gothenburg, Sweden
  5. 5Center for Sleep and Wake Disorders, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  6. 6Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
  7. 7Centre for Research and Development, Uppsala University/Region of Gävleborg, Gävle Hospital, Gävle, Sweden
  8. 8Department of Medicine, Blekinge Hospital, Karlskrona, Sweden
  1. Dr Magnus Ekström, Department of Medicine, Blekinge Hospital, SE-371 85 Karlskrona, Sweden. E-mail: pmekstrom{at}gmail.com

Abstract

Background The Swedish Registry of Respiratory Failure (Swedevox) collects nationwide data on patients starting continuous positive airway pressure (CPAP) treatment, long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT). We validated key information in Swedevox against source data from medical records.

Methods This was a retrospective validation study of patients starting CPAP (n=175), LTMV (n=177) or LTOT (n=175) across seven centres 2013–2017. Agreement with medical record data was analysed using differences in means (standard deviation) and proportion (%) of a selection of clinically relevant variables. Variables of interest included for CPAP: Apnea Hypopnea Index (AHI), height, weight, body mass index (BMI) and Epworth Sleepiness Scale (ESS) score; for LTMV: date of blood gas, PaCO2 (breathing air), weight and diagnosis group; and for LTOT: blood gases breathing air and oxygen, spirometry and main diagnosis.

Results Data on CPAP and LTOT had very high validity across all evaluated variables (all <5% discrepancy). For LTMV, variability was higher against source information for PaCO2 (>0.5 kPa in 25.9%), weight (>5 kg in 47.5%) and diagnosis group. Inconsistency was higher for patients starting LTMV acutely versus electively (PaCO2 –difference >0.5 kPa in 36% versus 21%, p<0.05, respectively). However, there were no signs of systematic bias (mean differences close to zero) across the evaluated variables.

Conclusion Validity of Swedevox data, compared with medical records, was very high for CPAP, LTMV and LTOT. The large sample size and lack of systematic differences support that Swedevox data are valid for health care quality assessment and research.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Ekström has nothing to disclose.

Conflict of interest: Dr. Albrecht has nothing to disclose.

Conflict of interest: Dr. Andersson has nothing to disclose.

Conflict of interest: Dr. Grote reports no conflict of intrest for the actual study, outside the submitted work Ludger Grote reports a a research collaboration with Bayer AG, non-financial support and other from Itamar Medical, Resmed, Philips, and Astra Zeneca; In addition, Dr. Grote has a patent on sleep apnea therapy issued and licensed.

Conflict of interest: Ms. Kärrsten-Rundström has nothing to disclose.

Conflict of interest: Dr. Palm has nothing to disclose.

Conflict of interest: Dr. Theorell-Haglöw has nothing to disclose.

Conflict of interest: Dr. Wahlberg has nothing to disclose.

Conflict of interest: Dr. Midgren has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received June 2, 2020.
  • Accepted October 16, 2020.
  • Copyright ©ERS 2020
http://creativecommons.org/licenses/by-nc/4.0/

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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