在加拿大行政数据中验证诊断码的使用,以识别药物不良事件
Maeve E Wickham1,2, Kimberlyn M McGrail2, Michael R Law2
1Department of Emergency Medicine, University of British Columbia, Vancouver, Canada.
British journal of clinical pharmacology
|April 11, 2024
概括
行政卫生数据对药物不良事件 (ADEs) 的记录很差. 研究人员应该探索替代方法,以准确地捕捉这些危害,以改善健康研究和患者安全.
科学领域:
- 医疗信息学 医疗信息学
- 药物监督 药物监督 药物监督
- 临床流行病学临床流行病学
背景情况:
- 管理健康数据,包括诊断码,越来越多地用于健康研究.
- 在行政数据中识别药物不良事件 (ADEs) 对患者安全和了解与药物相关的危害至关重要.
- 在现实世界的行政数据中捕获ADEs的诊断代码的准确性仍然不确定.
研究的目的:
- 为了验证基于声明的ADEs的诊断代码与前景识别的事件对抗.
- 评估不同的ADE检测诊断代码方案的敏感性和特异性.
- 确定ADEs的关键属性,从而预测其在行政健康记录中的记录.
主要方法:
- 在不列颠哥伦比亚省 (2008-2015,n=13,969) 的3个潜在队伍的回顾性分析.
- 将前性识别的ADEs与行政保险数据联系起来.
- 后勤回归分析以确定与ADE文档相关的因素.
主要成果:
- 对ADEs的诊断代码的灵敏度在3.4%至52.6%之间,根据数据库和代码集而异.
- 对于与剂量相关的事件 (OR:0.32) 和不坚持事件 (OR:0.35) 的记录显著较低.
- 对于心律失常的文档更高 (OR:4.19),尽管置信区间很宽.
结论:
- 药物不良事件在行政卫生数据中没有充分记录.
- 目前的诊断代码对于识别许多类型的ADEs的敏感性有限.
- 需要使用替代方法来可靠地捕获ADEs,以便进行可靠的健康研究.
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