用全国代表性的电子健康记录数据验证免疫率和风险的先天错误
Nicholas L Rider1, Ahuva Truxton2, Tracy Ohrt2
1Department of Health Systems and Implementation Science, Virginia Tech Carilion School of Medicine, Roanoke, Va.
The Journal of allergy and clinical immunology
|January 26, 2024
概括
十个警告标志有效地使用电子健康记录识别具有先天性免疫错误 (IEI) 的患者. 这项研究估计,IEI在美国影响了每1万个人中就有6人.
科学领域:
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
- 公共卫生 公共卫生
背景情况:
- "原发性免疫缺陷的十个警告标志"是30年前建立的,旨在提高对免疫的先天性错误 (IEI) 的识别.
- 之前对这些警告标志的评估没有利用人口层面的电子健康记录 (EHR) 数据.
- 需要在现实世界的临床数据中评估这些迹象的实用性.
研究的目的:
- 在一个大型的,代表性的美国患者队列中,评估识别两种或多种先天性免疫错误 (IEI) 预警信号 (WS) 的诊断价值.
- 为了估计美国人口中IEI的流行率.
主要方法:
- 一项队列研究分析了1.52亿美国患者的非识别EHR数据.
- 一个IEI队列 (n=41,080) 的确诊诊断被与匹配的对照组 (n=250,262) 相比较.
- 警告标志和诊断被编码,加权,并比较IEI病例和对照.
主要成果:
- 与对照组相比,IEI病例中显著增加的比例 (33%) 呈现出两种或更多的警告标志 (3.1%;P < .0005).
- 据估计,美国IEI的患病率为每10,000人中有6人.
- 预警标志9 (根深蒂固的感染),7 (真菌感染),5 (不能生长),和4 (复发性肺炎) 是最具预测性的.
结论:
- 在EHR数据中存在警告标志和相关诊断,可以帮助识别IEI患者.
- 据估计,在美国有15万到20万个人受到IEI的影响.
- 这项研究验证了IEI检测在大规模EHR数据中的警告标志的有用性.
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