Welcome

Jul 11, ’11 4:50 AM

Welcome to the (SPOT)light study blog which presents current information and news from the (SPOT)light light study, and from its sister study (SPOT)id.

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Week 3: Progress on the site report

Jan 21, ’12 3:43 AM

The draft site report has had an extra page added which shows the pattern of visits. If you’d like to have a look at this then please email at the usual address.

Other updates
- Two bugs in the tails matching reports have been corrected. The issue with a silly error which reported an impossible number of days between (SPOT)light visit and ICU admission has gone. There were also occasions when the matching status was not updating to reflect your latest returns. This too is now fixed.
- I think I have now contacted all sites in person with a copy of your latest matching report. Let me know if you need an update. The last match was run Week 2 2012. The next one is planned for Week 5.
- The DVR has been edited in response to your feedback, and we have been having our first reports completed. Thanks
- … and finally I am away next week so if you have any queries then please drop a line to Rahi or get in contact after the 30th

All the best
Steve

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Won’t you be missing data on patients seen but not admitted?

Jan 21, ’12 2:50 AM

This issue of missing the ‘non-admitted’ patients has been a massive source of anxiety for us. It is only relevant if you are following the ‘all referrals’ or ‘prospective data flow’ approach. In which case, then we have to completely depend on the quality of the initial data capture.

If a month’s data can only be completed by ‘backfilling’ (i.e. pulling notes) then we will flag that as a time period where it is likely that the patients not admitted are a biased sample. Where there is little ‘backfilling’ then we can be more sure that we have not missed patients seen but not admitted.

We will not discard any data but this will permit us to run a sensitivity analysis and makes sure that our conclusions are not affected by months with different levels of data completeness.

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Minor modifications to the DVR checks

Jan 21, ’12 2:02 AM

Just to let you know that we have adapted some of the checks on the DVR following some of your feedback.

- we have made the ‘impossible PaO2 for the reported FiO2′ check confirmable. It still remains impossible to have a PaO2 of 50 if you have only an FiO2 of 0.21 but if this is what is documented then please confirm this. We will of course remove these impossible values before using them in any analysis.

- the high pulse pressure check now will only fire if the difference between systolic and diastolic is >120mmHg rather than 100mmHg

- Isolated measurements of sodium will no longer trigger a request to check for missing values of urea and creatinine. Previously we had assumed that sodium would be most commonly measured with a laboratory U&E request and therefore it would be odd if creatinine was not reported. However since blood gas machines now frequently report sodium then we have removed the check.

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Critical Care Minimum Dataset – Update

Jan 20, ’12 12:52 AM

We have now run a successful export with one of the sites from WardWatcher. It doesn’t seem to bad. You will end up producing several different sheets (e.g. one for basic respiratory, one for advanced respiratory etc.). Each sheet will have one row per patient indexed by the patient’s CMP number. It should look something like …

            		ICNARC number   Days    Support
            		20110084    0   No, No, No, No, No
            		20110085    0   No, No, No, No, No, No, No
            		20110086    1   No, Yes, No

We’ll work through the other systems and then prepare detailed guidance. Please beware however that may of the automatic export options on the systems include patient identifiers which must be stripped out before sending to us. The only identifier we need (and can accept) is the ICNARC Case Mix Programme number.

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Week 2: Hiatus

Jan 13, ’12 12:43 AM

Sorry for the mid-week hiatus in email replies. Turns out that running the Heads’n'Tails match this week produced a series of problems that took quite a while to fix. Most importantly older matches were being dropped from the heads and tails reports. I think this is because there is a cooling off period that stops us looking at recently modified records.

Anyhow, I have tried to put together a work around but let me know if things don’t seem quite right.

Steve

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Week 1 of 12: 30 000 patients and counting!

Jan 6, ’12 9:28 PM

Why week 1 of 12? Because we are setting the deadline for final submission of (SPOT)light data to March 31 2012.  All sites have completed data collection, and the only factor now outside of our control is the timing of the submission of the Case Mix Programme (CMP) data that is used for matching. This is supposed to be submitted quarterly so since all sites finished last quarter then the corresponding CMP should be submitted over the next few weeks.

March 31 is less than 3 months away hence the countdown. I’ll try and post once a week about progress, and turn around submitted matching reports or DVR queries on a weekly basis.

I had hoped to send a mail shot out alerting everyone to the DVR which is now live, but I  started preparing the first pages of the site report and this took longer than I had planned.

The DVR mail shot should now go out on Monday.  This is not altogether bad as there is one annoying bug on the website at the moment which reports errors (accurately) but does not indicate which field is causing the problem.  The IT team have done a great job in sorting this one out, but it seemed sensible not to push everyone to look at the DVR before this was fixed.

Happy New Year! And I hope you are looking forward to the (SPOT)light results as much as I am!

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Bug report: Frequency of vital signs

Jan 4, ’12 9:56 PM

Currently the DVR thinks that if the ‘Frequency of vital signs’ drop down is blank then this means the frequency is less than 12 hourly. This causes a few DVR checks to fire incorrectly. Please ignore DVR checks involving this for now.I will post when the bug is fixed.

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Aaahhh … why is my DVR report so long?

Jan 3, ’12 6:31 PM

First of all we are very pleased with the data quality for (SPOT)light. We expect around 2-3 errors per record (on average) and the average is around 0.5 (or 1 every two records). However, if you have a large number of records then this still translates into a large number of checks and a lot of work.

So to justify this then here are a few of the most common DVR checks with an explanation to justify why we are asking for your help:

  • Unusual spelling for first names: We will be unable to match to death certificates with the Office of National Statistics if the name spelling is odd. We expect some false positives with unusual names but the system should learn as we go along. Unfortunately a decent number of records across the entire study have first and last name reversed, and so despite the false positives this is still an important check.
  • Follow-up or recommended level of care missing. We’ll use this to classify patients  - especially important is the case where treatment limits are in place and we don’t want to consider that patient’s subsequent death outside of ICU as unanticipated.

I’ll add other explanations as they come up.

Please do get in contact if you have any queries.

Steve

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Happy New Year … and a DVR explanation

Jan 3, ’12 6:25 PM

Q: Why are you asking me to confirm a blank field?

A: Nearly all the fields on the web site have a ‘Not available’ checkbox attached, and when you have checked this then we will not be asking you for further information. However, if the field is blank and the box is unchecked then we need to be sure that form is complete and the data is truly unavailable.

The only other time we will ask is where there are also ‘drop-down’ lists since these do not have paired ‘Not available’ checkboxes.  The only way that we can be sure that the data in these fields is truly unavailable is by asking you to confirm this.

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New icons on the web portal

Dec 6, ’11 8:12 PM

You will see a two clipboard icons on the web portal. These buttons are not yet ready for public release but we thought we would let you know what they will do in advance.

NewImage

The clipboard with the question mark is the button to produce your hospital’s Data Validation Report.

The clipboard with the exclamation mark should list all patients not meeting the minimum data set standard.

 

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