Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting

Long-term outcome ascertainment can be affected by the follow-up performance and needs to use a different data source for more comprehensive data capture. However, a universal tracking system is absent in Japan, and long-term outcomes are often ascertained through electronic medical records (EMRs),...

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Main Authors: Kensuke Yokoi, MD, Atsushi Tanaka, MD, Goro Yoshioka, MD, Masahiko Hara, MD, Keiji Kamohara, MD, Koichi Node, MD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Mayo Clinic Proceedings: Innovations, Quality & Outcomes
Online Access:http://www.sciencedirect.com/science/article/pii/S2542454824000572
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author Kensuke Yokoi, MD
Atsushi Tanaka, MD
Goro Yoshioka, MD
Masahiko Hara, MD
Keiji Kamohara, MD
Koichi Node, MD
author_facet Kensuke Yokoi, MD
Atsushi Tanaka, MD
Goro Yoshioka, MD
Masahiko Hara, MD
Keiji Kamohara, MD
Koichi Node, MD
author_sort Kensuke Yokoi, MD
collection DOAJ
description Long-term outcome ascertainment can be affected by the follow-up performance and needs to use a different data source for more comprehensive data capture. However, a universal tracking system is absent in Japan, and long-term outcomes are often ascertained through electronic medical records (EMRs), the reliability of which is uncertain. In this study, we compared EMR-based and direct outreach–based collections on outcome ascertainment accuracy in 500 patients who underwent coronary artery bypass grafting. Mortality data for all patients were extracted from the EMR, as standard data collection. When patient death was not confirmed in the EMR, we enhanced to collect updated mortality information by direct outreach to patients, their family, or their physicians, as enhanced direct outreach data. As a result, the Kaplan-Meier curves found a notable separation between different data sources analyzed. Interestingly, mortality events in the latter half of the follow-up period (median, 6.5 years) were overestimated in the EMR-based data collection analysis because of the reduced number of actively tracked cases, highlighting a potential bias in the EMR-based data collection on long-term prognoses. Our findings suggest that an active follow-up strategy with better adherence will enhance the accuracy of long-term outcome ascertainment and be helpful to build more reliable real-world evidence.
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spelling doaj-art-ece0dc1fd44b4e9aa6778709b28aea912024-12-06T05:13:59ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482024-12-0186502504Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass GraftingKensuke Yokoi, MD0Atsushi Tanaka, MD1Goro Yoshioka, MD2Masahiko Hara, MD3Keiji Kamohara, MD4Koichi Node, MD5Department of Cardiovascular Medicine, Saga University, Saga, JapanDepartment of Cardiovascular Medicine, Saga University, Saga, Japan; Correspondence: Address to Atsushi Tanaka, MD, Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.Department of Cardiovascular Medicine, Saga University, Saga, JapanDepartment of Clinical Investigation, Japan Society of Clinical Research, Osaka, JapanDepartment of Thoracic and Cardiovascular Surgery, Saga University, Saga, JapanDepartment of Cardiovascular Medicine, Saga University, Saga, JapanLong-term outcome ascertainment can be affected by the follow-up performance and needs to use a different data source for more comprehensive data capture. However, a universal tracking system is absent in Japan, and long-term outcomes are often ascertained through electronic medical records (EMRs), the reliability of which is uncertain. In this study, we compared EMR-based and direct outreach–based collections on outcome ascertainment accuracy in 500 patients who underwent coronary artery bypass grafting. Mortality data for all patients were extracted from the EMR, as standard data collection. When patient death was not confirmed in the EMR, we enhanced to collect updated mortality information by direct outreach to patients, their family, or their physicians, as enhanced direct outreach data. As a result, the Kaplan-Meier curves found a notable separation between different data sources analyzed. Interestingly, mortality events in the latter half of the follow-up period (median, 6.5 years) were overestimated in the EMR-based data collection analysis because of the reduced number of actively tracked cases, highlighting a potential bias in the EMR-based data collection on long-term prognoses. Our findings suggest that an active follow-up strategy with better adherence will enhance the accuracy of long-term outcome ascertainment and be helpful to build more reliable real-world evidence.http://www.sciencedirect.com/science/article/pii/S2542454824000572
spellingShingle Kensuke Yokoi, MD
Atsushi Tanaka, MD
Goro Yoshioka, MD
Masahiko Hara, MD
Keiji Kamohara, MD
Koichi Node, MD
Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting
Mayo Clinic Proceedings: Innovations, Quality & Outcomes
title Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting
title_full Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting
title_fullStr Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting
title_full_unstemmed Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting
title_short Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting
title_sort accuracy of outcome ascertainment in long term mortality after coronary artery bypass grafting
url http://www.sciencedirect.com/science/article/pii/S2542454824000572
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