帕金森病的诊断代码对于电子健康记录研究来说不够准确,并且因种族而异
Emily J Hill1, Jennifer Sharma1, Benjamin Wissel1
1Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA.
Parkinsonism & related disorders
|July 30, 2023
概括
对帕金森病 (PD) 的电子健康记录进行过,提高了准确性,特别是在黑人患者中. 然而,EPH数据中的PD诊断代码对于研究来说仍然不可靠,需要进一步调查.
科学领域:
- 神经学 神经学
- 生物医学信息学 生物医学信息学
- 数据科学数据科学数据科学
背景情况:
- 电子健康记录 (EHR) 数据对于帕金森病 (PD) 研究至关重要,但缺乏标准化的清洁指南.
- 目前使用国际疾病分类 (ICD) 代码的方法具有可变的准确性.
- 之前的研究并没有排除非典型的或药物诱导的帕金森症,并且在准确性方面种族差异的研究不足.
研究的目的:
- 评估是否排除帕金森症诊断可以提高PD诊断代码的准确性 (ICD-9和ICD-10).
- 评估过对不同种族群体的PD代码精度的影响.
主要方法:
- 包括至少有两种ICD-9或ICD-10PD代码的记录.
- 删除了带有非典型或药物诱导帕金森症代码的记录.
- 在过之前和过后,手动审查每组100个随机图表.
- 进行统计测试以比较PD病例确认率.
主要成果:
- 在过后,5633个初始记录中的2833个仍然存在.
- PD诊断代码的整体准确性很低,过后略有下降 (0.55至0.51).
- 准确度在黑人患者中最低 (0.48),但在过帕金森症代码 (0.68,p < 0.001) 后显著改善.
结论:
- 使用ICD-9和ICD-10代码的当前EHR数据表明PD诊断的准确性不足.
- 排除帕金森症代码提高了准确性,特别是在黑人患者中,尽管整体准确性仍然令人担忧.
- 这些发现强调了用于PD研究的现实世界EHR数据的局限性,并强调了需要改进数据清理策略和进一步研究的需要.
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