测试一种自动化方法,在多个地点识别1型糖尿病儿童的结果变化
Jessica Addison1, Hanieh Razzaghi2,3, Charles Bailey2,3
1From the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Mass.
Pediatric quality & safety
|April 8, 2024
概括
自动化电子健康记录 (EHR) 数据有效评估1型糖尿病 (T1D) 青少年的护理质量. 血糖控制和结果的重大机构变化凸显了需要改进糖尿病管理策略的需要.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 医疗保健服务研究 医疗服务研究
- 在医疗保健中的数据科学.
背景情况:
- 儿童1型糖尿病 (T1D) 的比较质量评估需要有效的数据收集方法.
- PCORnet的共同数据模型 (CDM) 在多个机构中标准化了电子健康记录 (EHR) 衍生的数据.
研究的目的:
- 确定使用自动化EHR数据进行儿科T1D的比较质量评估的可行性.
- 评估EHR数据的可靠性和有效性,以衡量T1D护理和结果.
主要方法:
- 在两个PCORnet网络 (PEDSnet,OneFlorida) 中评估了血糖控制,糖尿病酸性 (DKA) 病例和2016-2018年的诊所访问.
- 开发了基于EHR的措施规范,并使用CDM数据确定了特定机构的费率.
- 通过协议评估与手动图表审查验证了验证结果.
主要成果:
- 分析了12所机构9,740名患有T1D的年轻人的数据.
- 发现26%的人每年HbA1c>9%,中位数HbA1c为8.5%.
- 4%因DKA住院;PCORnet CDM预测值在所有措施中超过75%.
结论:
- 自动化EHR数据是评估T1D护理质量的有效,高效和可靠的工具.
- 观察到关心的重要机构差异,许多机构没有达到美国糖尿病协会的HbA1c目标 (<7.5%).
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