在初级保健中开发和验证有问题的更年期病例定义的电子医疗记录
Anh N Q Pham1, Michael Cummings2, Nese Yuksel3
1Department of Rehabilitation Medicine, University of Alberta, Edmonton, Canada. anh.pham@ualberta.ca.
BMC medical informatics and decision making
|October 5, 2023
概括
一个新的病例定义使用电子健康记录准确地识别了经历有问题的更年期的女性. 该工具有助于研究更年期,并改善患有更年期妇女的初级护理.
科学领域:
- 妇女健康 妇女健康
- 初级医疗保健医学 一级医疗保健医学
- 医疗信息学 医疗信息学
背景情况:
- 更年期对于女性来说是一种自然的生活过渡.
- 更年期症状可以显著影响一些人的生活质量.
- 制定精确的病例定义对于理解和管理有问题的更年期至关重要.
研究的目的:
- 开发和验证问题性更年期的病例定义.
- 在这个定义中使用加拿大初级保健电子医疗记录.
- 促进流行病学研究和改善更年期护理质量.
主要方法:
- 在加拿大初级保健哨兵监测网络的大数据集上使用机器学习 (分类和回归树).
- 使用的计费代码,诊断自由文本,问题列表,药物和转介.
- 应用特征重要性和递归特征消除,以精炼超过86,000个特征,使用类平衡技术.
主要成果:
- 在患者记录中使用ICD-9-CM代码627或ATC代码G03CA创建了一个病例定义.
- 这个定义取得了很高的有效性:81.5%的灵敏度和93.5%的特异性.
- 在检测有问题的更年期时,正预测值为73.8%,负预测值为95.7%.
结论:
- 对于有问题的更年期而言,开发的案例定义证明了其高度有效性.
- 这个定义适用于流行病学研究和更年期的监测.
- 它将支持未来对初级保健机构中更年期管理的调查.
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