使用电子健康记录诊断严重抑郁症和物质使用障碍:初步验证研究
Vinod Rao1, Sylvia Lanni1, Amy M Yule2
1Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Journal of mood and anxiety disorders
|September 11, 2023
概括
这项研究验证了一种使用电子健康记录来识别患有严重抑郁症 (MDD) 和物质使用障碍 (SUD) 的患者的方法. 该方法准确地识别了MDD,并显示了识别SUD的希望,支持EHR数据实用性.
科学领域:
- 医疗信息学 医疗信息学
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 调查主要抑郁症 (MDD) 和物质使用障碍 (SUD) 之间的联系需要准确的患者鉴定.
- 电子健康记录 (EHR) 为此类研究提供了丰富的自然数据来源.
- 需要标准化的方法来从电子健康记录中提取和验证诊断信息.
研究的目的:
- 提出和验证一种方法框架,用于识别MDD和非尼古丁SUD患者使用EHR数据.
- 评估由EHR变量衍生的代理诊断和索引日期的准确性.
主要方法:
- 开发了一个使用EHR数据的框架,包括计费代码,问题列表,患者报告的结果和处方,以建立MDD和SUD的代理诊断和索引日期.
- 在指数日期周围进行1年的手动图表审查,以验证代理诊断并评估疾病发病日期的准确性.
主要成果:
- 在主要抑郁障碍代理诊断中实现了100%的积极预测值.
- 对物质使用障碍的代理诊断显示与手册审查有很强的一致性 (科恩的卡帕=0.84),显示92%的灵敏度,特异性,积极预测值和负预测值.
- 通过EHR提取生成的16%的物质使用障碍指数日期中发现了不准确性,与图表识别的发病相比,差异超过6个月.
结论:
- 经过验证的方法对于识别患有MDD的患者是非常有效的,有或没有同时发生的SUD.
- 该框架在确定SUD的发病日期方面具有中等的有效性.
- 这些发现支持使用EHR数据来创建MDD和SUD的代理诊断.
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