邀请评论:关于儿科高血压的高压报警
1Division of Critical Care, Department of Pediatrics at Nemours Children's Hospital, Delaware.
American journal of epidemiology
|June 2, 2024
概括
儿科高血压可能比以前认为的更常见. 电子健康记录中的直接血压测量显示出比诊断代码建议的更高的比率,突出需要更好的检测和管理.
科学领域:
- 儿科医学 儿科医学
- 心血管流行病学心血管流行病学
- 医疗信息学 医疗信息学
背景情况:
- 儿童和青少年高血压的诊断不足.
- 目前的流行病学估计可能是不准确的,因为依赖于计费代码.
- 年轻人血压升高会造成长期的心血管健康风险.
研究的目的:
- 为了比较儿科高血压的患病率,使用直接血压测量与诊断码进行比较.
- 评估电子健康记录在识别儿科高血压时的准确性.
- 突出需要改善儿童群体的高血压检测.
主要方法:
- 利用美国食品和药物管理局的哨兵系统,分析了375万次儿科医疗保健访问.
- 将"临床队列" (来自EHR的直接血压测量) 与"基于索赔的队列" (诊断代码) 相比较.
- 包括住院和门诊访问以提取数据.
主要成果:
- 对血压测量的直接评估表明,儿童和青少年的高血压患病率高于以前使用索赔代码估计的.
- 电子健康记录数据提供了对儿科高血压患病率的更全面的了解.
- 在电子健康记录中存在错误分类偏差的可能性.
结论:
- 仅依靠ICD-9-CM/ICD-10-CM代码就低估了儿科高血压.
- 来自EHR的直接临床数据对于准确的流行病学估计至关重要.
- 改善儿童高血压的识别可以提高长期心血管健康结果.
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