通过Rx-风险并发症指数使用药物概念对多病症进行分类:方法和比较横截面研究
Jared J Vanderbleek1, Justin K Owensby2, Alex McAnnally3
1University of Alabama at Birmingham and University of Alabama at Birmingham Hospital.
Arthritis care & research
|November 21, 2023
概括
一个新的以药物为重点的并发症指数Rx-Risk有效地识别电子健康记录 (EHR) 中的并发症状况,其中诊断可能会错过. 与传统指数相比,这种方法显著改善了并发症评估.
科学领域:
- 药理学和健康信息学 医药学和健康信息学
- 临床流行病学临床流行病学
- 电子健康记录 (EHR) 数据分析 数据分析
背景情况:
- 在单一专业的电子健康记录中,诊断代码可能不足以捕捉伴随疾病的情况.
- 准确的并发症评估对于患者护理和研究至关重要.
- 药物数据为识别并发症提供了潜在的替代方案.
研究的目的:
- 更新一种仅使用药物信息识别并发症的方法.
- 在特定的EHR环境中解决诊断不足的问题.
- 将Rx风险指数与传统的并发症指数进行比较.
主要方法:
- 将药物数据 (RxCUIs,NDCs,ATC代码) 映射到Rx风险指数中.
- 使用第一数据库,RxNorm,RxNav和RxClass进行数据映射.
- 在类风湿性关节炎 (RA) 和骨关节炎 (OA) 队列中,Rx-风险得分与查尔森,RDCI和Elixhauser指数进行比较.
主要成果:
- 在46个Rx风险类别中确定了965个独特的成分RxCUI,绘制了超过80,000个RxCUI.
- 在RA和OA队列中,Rx风险得分明显高于查尔森,RDCI和Elixhauser.
- 在查尔森得分为0的患者中,Rx风险得分差异很大 (0-16+),与其他指数不同.
结论:
- 像Rx-Risk这样的以药物为中心的指数可以在很大程度上克服错误分类和在单一专业的EHR中不充分确定并发症.
- Rx-Risk提供了对伴随性疾病负担的更全面的评估,特别是在诊断数据有限的人群中.
- 这种方法增强了EHR数据对于流行病学研究和临床决策的有用性.
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