Quality of HIV Testing Data Before and After the Implementation of a National Data Quality Assessment and Feedback System
CONTEXT:
In
2010, the Centers for Disease Control and Prevention (CDC) implemented a
national data quality assessment and feedback system for CDC-funded HIV testing program data.
OBJECTIVE:
Our
objective was to analyze data quality before and after feedback.
DESIGN:
Coinciding
with required quarterly data submissions to CDC, each health department
received data quality feedback reports and a call with CDC to discuss the
reports. Data from 2008 to 2011 were analyzed.
SETTING:
Fifty-nine
state and local health departments that were funded for comprehensive HIV prevention services.
PARTICIPANTS:
Data
collected by a service provider in conjunction with a client receiving HIV testing.
INTERVENTION:
National
data quality assessment and feedback system.
MAIN OUTCOME MEASURES:
Before
and after intervention implementation, quality was assessed through the number
of new test records reported and the percentage of data values that were
neither missing nor invalid. Generalized estimating equations were used to
assess the effect of feedback in improving the completeness of variables.
RESULTS:
Data were
included from 44 health departments. The average number of new records per
submission period increased from 197 907 before feedback implementation to 497
753 afterward. Completeness was high before and after feedback for
race/ethnicity (99.3% vs 99.3%), current test results (99.1% vs 99.7%), prior
testing and results (97.4% vs 97.7%), and receipt of results (91.4% vs 91.2%).
Completeness improved for HIV risk (83.6% vs 89.5%), linkage to HIV care (56.0% vs 64.0%), referral to HIV partner services (58.9% vs 62.8%), and
referral to HIV prevention
services (55.3% vs 63.9%). Calls as part of feedback were associated with
improved completeness for HIV risk
(adjusted odds ratio [AOR] = 2.28; 95% confidence interval [CI], 1.75-2.96),
linkage to HIV care
(AOR = 1.60; 95% CI, 1.31-1.96), referral to HIV partner
services (AOR = 1.73; 95% CI, 1.43-2.09), and referral to HIV prevention services (AOR = 1.74; 95% CI,
1.43-2.10).
CONCLUSIONS:
Feedback
contributed to increased data quality. CDC and health departments should
continue monitoring the data and implement measures to improve variables of low
completeness.
- 1US Public Health Service and Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Beltrami and Mr Wang); Alberta Health Services, Surveillance and Reporting, Edmonton, Alberta, Canada (Dr Usman); and Department of Mathematical Sciences, Montana State University, Bozeman (Dr Lin).
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