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電子情報源からの心臓血管データの有効性:動脈硬化と健康に関する多民族研究LNK

Faraz S Ahmad¹, Cheeling Chan¹, Marc B Rosenman¹

¹From Division of Epidemiology, Department of Preventive Medicine (F.S.A., C.C., P.G., K.J.L., N.B.A.); Division of Cardiology, Department of Medicine (F.S.A., P.G.); Department of Pediatrics (M.B.R.); The Center for Health Information Partnerships (CHiP), Institute of Public Health & Medicine (M.B.R., A.N.K.); Division of Health and Biomedical Informatics, Department of Preventive Medicine (D.G.F.); Division of General Internal Medicine and Geriatrics, Department of Medicine (A.N.K.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (W.S.P.).

|July 9, 2017

まとめ

電子医療記録は,従来の研究方法と比較して,心血管データを正確に収集する際の限界を示しています. ボディ・マス・インデックスデータは高度に相関しているが,血圧と心血管疾患のデータは研究用に慎重に検証する必要がある.

科学分野:

心血管研究
医療情報学
流行病学について

背景:

電子データ研究ネットワークの有効性は,国家研究イニシアチブと心血管医療の学習医療システムにとって極めて重要です.
この研究では,電子データ研究ネットワークとコホート研究における標準化された研究アプローチからのデータの一致を評価します.

研究の目的:

電子医療記録 (HealthLNK) と標準化されたコホート研究 (Multi-Ethnic Study of Atherosclerosis - MESA) の間の血圧と体量指数 (BMI) の相関性と一致性を評価する.
高血圧,肥満,糖尿病の電子医療記録の診断性能を評価する.
電子医療記録で特定された心血管疾患 (心筋梗塞,脳卒中,心不全) とコホート研究で判定された疾患を比較する.

主な方法:

MESAコホートからの個人レベルのデータをHealthLNKの電子医療記録データベース (2006年−2012年) とリンクした.
血圧とBMIを比較するためにピアソン相関係数とBland-Altmanグラフを使用した.
ICD-9コードと臨床データを用いて,高血圧,肥満,糖尿病の診断に対する感度と特異性を計算した.
HealthLNKで特定された心血管疾患と判断されたMESA疾患を比較した.

主要な成果:

1164人のMESA参加者のうち802人 (68. 9%) がHealthLNKにデータを持っていた.
シストリック血圧の低相関 (0. 39) とHealthLNKの過大評価; BMIの高相関 (0. 94) とわずかな過小評価.
健康LNKは高血圧では82. 4%/59. 4%,肥満では73. 0%,糖尿病では79. 8%/93. 3%の感度/特異性を示した.
心筋梗塞,脳卒中,心不全のコンコンダンス率はそれぞれ41. 7%,61. 5%,62. 5%でした.

結論:

電子データリポジトリは,従来の流行病学的方法と比較して,心臓血管リスク因子や事象を正確に確認する上で限界があります.
発見は,心臓血管研究のための電子医療記録の使用の強みと弱みを強調し,慎重にデータの検証の必要性を強調しています.

キーワード:

心血管疾患データの正確性電子医療記録流行病学についてコンピュータリスク要因

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