Miss Jackie Lee Hazelhurst1, C WALKER2, J KEARNS3, M JONES3, J HEDLEY4, RB CUTTING4, NB CROSS5,6, L BECKERT1,5, SC GREEN7, AC WEBSTER4
1University Of Otago, , Aotearoa / New Zealand, 2Te Whatu Ora Te Pae Hauora o Ruahine o Tararua, Palmerston North, Aotearoa / New Zealand, 3Kidney Health New Zealand, Christchurch, Aotearoa / New Zealand, 4Sydney School of Public Health, University of Sydney, , Australia, 5Te Whatu Ora Waitaha, Christchurch, Christchurch, Aotearoa / New Zealand, 6New Zealand Clinical Research, , Aotearoa / New Zealand, 7 Dean’s Department, Dunedin School of Medicine, Dunedin, Aotearoa / New Zealand
Biography:
Jackie Hazelhurst is a final year medical student at Otago Medical School, based in Whakatū Nelson. In 2024 she completed a BMedSc(Hons), with Professor Suetonia Green as her primary supervisor, focused on the accuracy of ethnicity data in chronic kidney disease registries. She has an interest in medical humanities, data equity, and the use of artificial intelligence in medicine.
Aim:
To evaluate agreement in ethnicity reporting among health services data sources for kidney failure within Aotearoa New Zealand.
Background:
Accurate ethnicity reporting is a fundamental component of monitoring inequities in health outcomes for Indigenous and minoritised peoples. Routine data quality audits enable an assessment of the quality of ethnicity data in registries.
Methods:
We evaluated the accuracy of ethnicity recording in the Australia and New Zealand Dialysis and Transplantation registry (ANZDATA) for Māori with kidney failure between 2006 to 2019 in Aotearoa New Zealand. Non-standardised registry data (ANZDATA) were compared with standardised hospitalisation data (National Minimum Dataset) as the reference standard using deterministic data linkage. Outcomes were measures of agreement between datasets (sensitivity, specificity, positive and negative predictive values) overall and by demographic and clinical characteristics; trends in sensitivity over time.
Results:
Of 7648 people commencing kidney replacement therapy, 2431 (31.8%) were identified as Māori using standardised methods in hospitalisation data, of which the registry recorded 2299 (94.6%). Overall sensitivity of the registry for Māori was 94.6% (95% confidence interval (CI) 93.6–95.4%), with high specificity (98.5%, CI 98.1–98.8%). Inter-rater reliability (Cohen’s kappa) exceeded 0.81 both overall and in subgroup analyses, suggesting high agreement between the datasets. Non-reporting of Māori identification in ANZDATA was associated with a shorter time to kidney transplantation (HR 2.20, CI 1.39–3.51), however there was no evidence of an association between ethnicity reporting concordance with all-cause death (HR 0.80, CI 0.60–1.06). Agreement of ethnicity reporting remained consistent over time.
Conclusion:
Despite non-standardised ethnicity data collection in ANZDATA, there was consistently high agreement between registry and hospitalisation data over the study period for Māori.
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