验证成人喘病例定义,用于初级保健的哨戒监测
Max Moloney1,2, Alison Morra3,4, Rachael Morkem5
1Asthma Research Unit, Kingston General Hospital, Kingston Health Sciences Centre at Queen's University, 72 Stuart Street, Kingston, ON, K7L 2V7, Canada. max.moloney@queensu.ca.
概括
这项研究开发并验证了在初级保健中疑似或确诊喘的电子病历 (EMR) 病例定义. 该工具有助于监测和提高成人喘管理的质量.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗信息学 医疗信息学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 喘诊断和护理主要发生在初级保健机构.
- 电子医疗记录 (EMR) 提供了改善喘诊断和患者管理的机会.
- 经过验证的EMR病例定义对于监测,基准测试和初级保健质量改进至关重要.
研究的目的:
- 在初级保健EMR中为疑似和确诊的喘创建和验证不同的病例定义.
- 为了实现强有力的喘监测,基准测试和质量改进计划.
- 为可疑和确诊的喘制定一个适合初级保健哨兵监测系统的病例定义.
主要方法:
- 进行了一项手动审计,对来自学术初级保健EMR的776份患者病历进行了手动审计.
- 喘的共识分类 (不是喘,疑似喘,确诊喘) 使用加拿大胸腔学会 (CTS) 标准实现.
- 基于计费代码,临床数据和药物的算法应用于加拿大初级保健哨兵监测网络 (CPCSSN) 数据,并与图表分类进行比较.
主要成果:
- 疑似和确诊喘的患病率分别为7.3%和2.4%.
- 没有单一的算法可以区分疑似和确定的喘.
- 结合计费,临床和药物元素的算法在联合疑似或确诊的喘中显示出高性能 (尤登指数:0.77,灵敏度:81%,特异性:96%).
结论:
- 已验证的EMR病例定义可用于疑似或确诊的成人喘,可用于CPCSSN.
- 这种案例定义有助于创建成人喘电子监控工具 (eTool).
- 预计eTool将促进成人喘护理的质量提高.
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