Comparing reported management of ureteric stones between clinical audit and administrative datasets: An opportunity to streamline clinical audit.

Objectives: To compare recorded patient management between a clinical audit and administrative dataset for patients presenting with ureteric stones in England and to assess the feasibility of using administrative data for routine audit.

Patients And Methods: The British Association of Urological Surgeons conducted a clinical audit of all patients presenting as an emergency to 107 hospitals in England during November 2020 with ureteric stones. All patients were followed up until 31st March 2021 and in-patient and out-patient management received recorded. These clinical audit data were compared to those available from the English Hospital Episode Statistics (HES) administrative database covering the same time period.

Results: Data were available for 2344 patients from HES, and 2050 patients admitted to the same 107 hospitals from clinical audit. The two cohorts were well matched for age (mean 47.2 years and 49.3 years respectively), but with a higher proportion of females in the HES dataset (42.2 % vs 30.1 %). Recorded treatment received was similar in both cohorts, other than for ureteroscopy, which was significantly under recorded in HES, most obviously following initial stent placement (17.2 % vs 26.0 % ureteroscopy as final management respectively).

Conclusions: The two data sources were generally well matched in terms of patient numbers, age and management. The higher number of patients and females in HES may be due to initial misdiagnosis of abdominal pain as ureteric stones in females. The reasons for discrepancies in recording of ureteroscopy are unclear and warrant further investigation. Administrative data can complement clinical audit data and streamline the audit process, but issues around data quality should be studied prior to use of administrative data for this purpose.