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来自电子来源的心血管数据的有效性:动脉样硬化和健康的多民族研究

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

概括

与传统研究方法相比,电子健康记录在准确捕获心血管数据方面存在局限性. 虽然体重指数数据高度相关,但血压和心血管事件数据需要仔细验证以用于研究.

科学领域:

心血管研究
卫生信息学
流行病学

背景情况:

电子数据研究网络的有效性对于国家研究倡议和学习心血管保健系统至关重要.
本研究评估了电子数据研究网络与在队列研究中的标准化研究方法数据之间的一致性.

研究的目的:

评估电子健康记录 (HealthLNK) 和标准化队列研究 (动脉样硬化多民族研究 - MESA) 之间的血压和体重指数 (BMI) 的相关性和一致性.
评估高血压,肥胖和糖尿病的电子健康记录的诊断性能.
将电子健康记录中发现的心血管事件 (心肌梗塞,中风,心力衰竭) 与队列研究中判断的事件进行比较.

主要方法:

将MESA队列的个人数据与HealthLNK电子健康记录数据库 (2006-2012) 联系起来.
使用皮尔森相关系数和布兰德-阿尔特曼图来比较血压和BMI.
使用ICD-9代码和临床数据计算高血压,肥胖和糖尿病诊断的敏感性和特异性.
在HealthLNK中比较已确定的心血管事件与已确定的MESA事件.

主要成果:

在1164名MESA参与者中,有802人 (68.9%) 在HealthLNK中拥有数据.
缩血压的低相关性 (0.39) 与HealthLNK的高估值; BMI的高相关性 (0.94) 与轻微低估值.
对于高血压,LNK的敏感性/ 特殊性为82. 4% / 59. 4%,对于肥胖症为73. 0% / 89. 8%,对于糖尿病为79. 8% / 93. 3%.
心肌梗塞,中风和心力衰竭的一致率分别为41. 7%,61. 5%和62. 5%.

结论:

与传统的流行病学方法相比,电子数据库在准确确定心血管风险因素和事件方面存在局限性.
这些发现突出了使用电子健康记录进行心血管研究的优缺点,强调需要仔细验证数据.

关键词:

心血管疾病数据准确性电子健康记录流行病学数据科学危险因素

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