在初级和二级护理数据中识别接受慢性脏替代疗法的患者:基于OpenSAFELY和英国脏注册表的验证研究
Shalini Santhakumaran1, Louis Fisher2, Bang Zheng3
1UK Renal Registry, UK Kidney Association, Bristol, UK.
BMJ medicine
|April 22, 2024
概括
主要和次要护理代码准确地识别出流行置换治疗患者,但与事件病例作斗争. 糟糕的编码影响了患者护理和研究,突出了改善电子健康记录数据质量的需要.
科学领域:
- 医疗信息学 医疗信息学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
背景情况:
- 准确识别接受置换疗法 (KRT) 的患者对于研究和患者护理至关重要.
- 电子健康记录 (EHR) 越来越多地使用,但它们对特定条件的编码准确性,如KRT,需要与黄金标准数据进行验证.
- 英国脏注册局 (UKRR) 作为英国KRT数据的黄金标准.
研究的目的:
- 验证EHR中初级和二级护理代码的准确性,以识别接受慢性脏替代疗法的个人.
- 将这些代码的性能与金级标准的英国脏注册数据进行比较.
- 评估数据来源之间的一致性,考虑治疗方式和患者特征.
主要方法:
- 一项使用OpenSAFELY和英国脏注册局 (UKRR) 数据的验证研究.
- 包括英语通用诊所的流行 (2020年1月1日) 和事故 (2020年期间) KRT患者.
- 与UKRR数据相比,EHR代码列表的灵敏度和积极预测值的分析.
主要成果:
- EHR代码对流行的KRT患者表现出高灵敏度,但对偶发的KRT患者的灵敏度较低.
- 积极的预测值通常很低,尤其是慢性透析代码.
- 代码的准确性因年龄,社会经济地位和治疗方式而异,儿童的准确性较低.
结论:
- 初级和二级保健代码在充分捕捉流行和发生的KRT人群方面存在局限性,特别是在透析方面.
- 电子健康记录中的编码不准确会对患者护理,资源分配和公共卫生政策产生重大影响.
- 将EHR数据与UKRR数据联系起来可以提高识别KRT研究队列的准确性,但强调需要更好的编码实践.
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01:27Dialysis
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