Background and objective

The Baby-Friendly Hospital Initiative (BFHI) is an international strategy aimed at improving breastfeeding practices in health care services. Regular monitoring of indicators is key for BFHI implementation and maintenance. Currently, routine data collected from electronic health records (EHR) is an excellent source for infant feeding monitoring, however data quality (DQ) assessment should be undertaken. The aim of this research is to enable robust estimations of infant feeding indicators through DQ assessment of routine EHR data.

Materials and methods

We use the longitudinal series of healthcare contacts belonging to 6427 children born from 2009 to 2018 in the Health Area V of Murcia (Spain). Longitudinal data came from EHR at hospital discharge and community infant health reviews up to 18 months. The data of each healthcare contact contained a 24-h recall of infant feeding. We perform a DQ process in three phases: (1) an assessment of each-single-contact and the definition of their infant feeding status; (2) a longitudinal DQ assessment of completeness and consistency of the series of contacts to obtain meta-information that guides the duration calculus, for each case, of the different types of breastfeeding: exclusive breastfeeding (EBF), full breastfeeding (FBF) and any breastfeeding (ABF); and finally (3) a robust estimation of indicators and description of DQ of each indicator.

Results

We found deficiencies of DQ in 30.42% of single contacts for EBF, 19.02% for FBF and 22.50% for ABF that were used to establish the infant feeding status. However, after longitudinal DQ assessment, we obtained valid and reliable data rates for most indicators such as “median duration of breastfeeding” nearly 90%, both for FBF and ABF, not so for EBF.

Conclusions

Despite the DQ deficiencies found in raw data, the DQ assurance approach by indicators proposed in this work, allowed us to obtain a robust estimation of indicators with a significant percentage of subjects with valid information for ABF and FBF monitoring. The estimations were consistent with results previously published. The methodology provided with this study allows a continuous and reliable population monitoring of infant feeding indicators of BFHI from routine EHR data.

中文翻译：

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通过从出生到 18 个月的纵向电子健康记录的数据质量评估对婴儿喂养指标的稳健估计

背景和目的

爱婴医院倡议 (BFHI) 是一项旨在改善医疗保健服务中母乳喂养实践的国际战略。定期监测指标是 BFHI 实施和维护的关键。目前，从电子健康记录 (EHR) 收集的常规数据是婴儿喂养监测的极好来源，但应进行数据质量 (DQ) 评估。本研究的目的是通过对常规 EHR 数据的 DQ 评估，实现对婴儿喂养指标的稳健估计。

材料和方法

我们使用属于 2009 年至 2018 年在穆尔西亚（西班牙）卫生区 V 出生的 6427 名儿童的纵向系列医疗保健联系人。纵向数据来自出院时的 EHR 和长达 18 个月的社区婴儿健康审查。每个医疗保健联系人的数据都包含对婴儿喂养的 24 小时召回。我们分三个阶段执行 DQ 流程：(1) 对每个单一接触者的评估及其婴儿喂养状态的定义；(2) 对一系列接触的完整性和一致性的纵向 DQ 评估，以获得元信息，指导每种情况下不同母乳喂养类型的持续时间计算：纯母乳喂养 (EBF)、全母乳喂养 (FBF) 和任何母乳喂养 (ABF)；最后 (3) 对指标的稳健估计和每个指标的 DQ 描述。

结果

我们发现 30.42% 的 EBF 单次接触、19.02% 的 FBF 和 22.50% 的 ABF 用于建立婴儿喂养状态的 DQ 缺陷。然而，在纵向 DQ 评估后，我们获得了大多数指标的有效和可靠数据率，例如“母乳喂养的中位持续时间”接近 90%，FBF 和 ABF 均如此，EBF 并非如此。

结论

尽管在原始数据中发现了 DQ 缺陷，但这项工作中提出的指标的 DQ 保证方法使我们能够获得对指标的稳健估计，其中很大比例的受试者具有 ABF 和 FBF 监测的有效信息。这些估计与先前公布的结果一致。本研究提供的方法允许从常规 EHR 数据中对 BFHI 的婴儿喂养指标进行持续和可靠的人口监测。