Pressure Injury Data Reconciliation in a Randomized Controlled Trial

Arch Phys Med Rehabil, 2023 · DOI: 10.1016/j.apmr.2023.04.009 · Published: November 1, 2023

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

This study focuses on the challenges of collecting and reconciling data related to pressure injuries (PrI) in individuals with spinal cord injury (SCI) participating in a research trial. Pressure injuries are a common and serious complication for people with SCI, so accurately tracking and preventing them is very important. The researchers used multiple sources of information, including phone interviews, skin checks, and medical records, to identify and monitor PrIs. They found that relying on a single data source was insufficient and that careful reconciliation of information from different sources was necessary to ensure accuracy. The goal of the study was to learn lessons that could improve future PrI research and ultimately lead to better prevention and treatment strategies for individuals with SCI who are at high risk for developing these injuries.

Study Duration

2 Years

Participants

232 participants with SCI

Evidence Level

Level 1, Randomized Controlled Trial

Key Findings

1
Medical records were the most sensitive data source, detecting 82% of medically serious pressure injuries (MSPrIs).
2
Scheduled skin checks were the second-most sensitive data source, finding 37% of the MSPrIs.
3
Participants with a higher number of pressure injuries were less likely to report them during phone interviews.

Research Summary

This study examined the process of collecting and reconciling pressure injury (PrI) data from a randomized controlled trial involving individuals with spinal cord injury (SCI). Multiple data sources, including phone interviews, skin checks, and medical records, were used to identify medically serious PrIs (MSPrIs). The study found that medical record review was the most effective method for identifying MSPrIs, but no single data source captured all instances. Data reconciliation was crucial to ensure accuracy and avoid double-counting PrIs. The findings highlight the challenges of accurately tracking PrIs in community-dwelling individuals with SCI and provide recommendations for improving data collection and reconciliation processes in future research.

Practical Implications

Improved Research Methodology

Future studies should incorporate detailed data reconciliation processes from the start, including variables that facilitate linking a new PrI datapoint to others already identified, regardless of the data source.

Clinical Practice

Healthcare providers should utilize multiple data sources, including medical records, skin checks, and patient reports, to comprehensively assess and monitor pressure injuries.

Electronic Health Records

Healthcare facilities should ensure that electronic health records (EHRs) are designed and implemented effectively to facilitate documentation speed, efficiency, accuracy, and comprehensiveness in pressure injury management.

Study Limitations

1
Lack of a pre-planned standard system for evaluating all sources together and tracking data discrepancies.
2
Potential for previously held views of data source reliability to influence adjudicators' decisions.
3
The overall process may have missed some PrI, accuracy measures are understated for less-trusted sources and overstated for the others.

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