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Cohort study
Pitfalls of administrative database analysis are evident when assessing the ‘weekend effect’ in stroke
  1. Frank J Attenello,
  2. William J Mack
  1. Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  1. Correspondence to: Professor William J Mack, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90089-9034, USA; mackw{at}usc.edu

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Multiple studies attempt to clarify the role of weekend admissions in stroke.1 ,2 Recent studies have leveraged large populations in administrative databases to retrospectively evaluate hypotheses. While these studies disagree as to whether weekend admissions are associated with increased stroke mortality, concern exists regarding inherent limitations of administrative coding databases, including accuracy of patient and disease variables.3 Concern is justified, as coding inaccuracies unduly influence the study results. The Oxford Vascular Study (OXVASC), in contrast, contains detailed, comprehensive data prospectively recorded for all patients registered in Oxfordshire, the UK. The reviewed study admirably addresses administrative database accuracy, comparing data extracted from hospital coding with prospective OXVASC data, focusing on the accuracy of weekend versus weekday cohorts. …

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