Accurate case finding using linked electronic clinical and administrative data at a children's hospital

To link hospital administrative data and an electronic medical record at a children's hospital in order to identify children with cancer admitted for fever and neutropenia. Hospital administrative data concerning 13,374 inpat ient and outpatient encounters were validated against and linked to clinica l data stored in an electronic medical record. Queries of the linked databa ses identified children with fever and neutropenia. Sensitivity and specifi city of the experimental case-Finding strategy were determined and compared to a control case-finding strategy utilizing administrative data alone. Li nking of the clinical record to the administrative record was achieved in 2 33 (99%) of the 235 records. Of 1680 data elements reviewed from the admini strative data that were also potentially available in the clinical data sys tem, 1679 (99.9%) were verified in the electronic medical record. The exper imental strategy for case finding had a sensitivity of 73.1% (95% Cl: 58.1, 88.3), specificity 99.6% (95% Cl: 99. 1, 100). If only administrative data such as diagnosis-related group and hospital service were used for case fi nding, both the sensitivity (P < 0.01) and specificity (P < 0.01) were sign ificantly lower. Linking a children's hospital administrative data system w ith clinical data is feasible and can be utilized for specific case finding for a common and costly condition in children. (C) 2001, Elsevier Sicence Inc. All rights reserved.