我们集合中的缺陷:一种混合方法 临床价值组错误的分析
medRxiv : the preprint server for health sciences
|March 10, 2025
概括
临床值设置错误很常见,通常是由于缺失或误解的代码造成的. 改进价值管理工具对于准确的临床决策支持和质量测量至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 临床数据管理 临床数据管理
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 临床价值集对于电子健康记录 (EHR) 中数据的标准化至关重要.
- 值组中的错误可能会对临床决策支持 (CDS),质量测量和患者护理产生负面影响.
- 在价值设定识别,创建和维护方面存在的挑战需要进行系统的调查.
研究的目的:
- 描述临床价值设置问题的性质和频率.
- 确定临床价值集中错误的常见模式和根本原因.
- 评估价值设置变化对临床质量措施的影响.
主要方法:
- 与26位价值设定专家进行了半结构化采访.
- 进行了对EHR错误的根本原因分析.
- 从价值设置权威中心 (VSAC) 分析了用户报告的问题.
- 来自多个来源的经过审计的药物价值集.
- 评估了价值设置变化的影响对临床质量衡量的影响.
主要成果:
- 42%的错误涉及缺少的代码,14%的外来代码,40%的错误解释意图.
- 72%的错误是在价值组创建时存在的.
- 50%的经过审计的药物价值组包含错误,主要是遗漏.
- 价值组选择变化改变了临床质量测量结果的3到30倍.
结论:
- 价值设置错误很普遍,并源于可识别的原因.
- 描述错误模式可以为最佳实践和解决方案提供信息.
- 迫切需要改进价值设定创作,审计和监控的工具.
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