E-Posters-Validation of vaginal apical reconstructive procedures in health administrative database research: A Systematic Review

Validation of vaginal apical reconstructive procedures in health administrative database research: A Systematic Review - You (Maria) Wu, MD, MSc

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This systematic review examines the validation of vaginal apical reconstruction (VAR) procedure codes in health administrative database research on pelvic organ prolapse (POP) treatment. The review included 29 studies from January 2004 to February 2018, with the majority originating from the USA. The analysis found that the performance and reporting of VAR procedure code validation were inconsistent across different surgical categories. Validation studies were more commonly performed for sacrocolpopexies (SCPs) and non-mesh vaginal vault suspensions (VVS) compared to vaginal vault repairs (VVR-NOS), and were more prevalent in high impact journals. However, overall, the methodologies of VAR procedural code validation and case ascertainment were inadequately performed.<br /><br />Of the included studies, 41.4% evaluated surgical outcomes such as mortality, complications, and re-operation rates. The median impact factor of the published journals was 2.78. Among studies examining SCP outcomes, only 1 out of 12 studies reported validation against a reference standard with a concordance rate of 95%. For studies examining VVS outcomes, 2 out of 9 studies reported VAR procedural code validation with concordance rates ranging from 80% to 96%.<br /><br />This review highlights the need for more rigorous validation studies to ensure the accuracy and validity of data in health administrative database research on VAR procedures for POP treatment. The inconsistent and poor performance of VAR procedure code validation calls for improved reporting transparency and methodology. Although health administrative databases provide valuable information, more robust validation studies are necessary to strengthen the reliability of findings in this field of research.

Keywords

systematic review

vaginal apical reconstruction

VAR procedure codes

health administrative database research

pelvic organ prolapse

sacrocolpopexies

VVS

vaginal vault repairs

surgical outcomes

reliability