开发和验证丸激素处方的质量措施
Ann M Borzecki1,2,3, Jennifer Conti1, Joel I Reisman1
1Center for Healthcare Organization & Implementation Research, Bedford Site, VA Bedford Healthcare System, Bedford, MA 01730, USA.
Journal of the Endocrine Society
|June 26, 2023
概括
新的质量测量准确地评估了的处方. 这些基于电子健康记录 (EHR) 的工具可以识别缺口并改善患有阴道腺缺陷症的男性的护理.
科学领域:
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
背景情况:
- 改善的处方实践需要准确的评估工具.
- 目前评估丸激素处方适当性的方法缺乏.
研究的目的:
- 开发和验证质量措施,以启动和监测疗法.
- 创建可靠的指标来评估的处方做法.
主要方法:
- 在退伍军人卫生管理局 (VA) 开始测试的男性患者的回顾性队列研究.
- 使用VA电子健康记录 (EHR) 数据,内分泌学会指导方针和专家意见制定16项质量措施 (9项启动,7项监测).
- 通过对142名患者的手动图表审查评估标准有效性,计算正预测值 (PPV),负预测值 (NPV),整体准确性 (OA) 和马修斯相关系数 (MCC).
主要成果:
- 基于实验室数据的10项测量显示出高有效性 (PPV>78%,NPV>98%,OA>94%,MCC>0.85).
- 使用诊断码进行的6项测量结果显示,NPV (100%) 和OA (≥98%) 均为优异的.
- 由于病例数较少,与急性疾病 (心肌梗塞,中风) 和新诊断 (前列腺癌,乳腺癌) 相关的措施观察到较低的PPV.
结论:
- 已开发出基于验证的电子健康记录 (EHR) 的丸素处方质量指标.
- 这些措施可用于识别丸激素处方的质量差距.
- 实施这些措施可以改善对男性的护理 阴道腺乱.
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