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在观察性研究中用于识别外围动脉疾病的电子表型化方法的范围审查
Abena Appah-Sampong1,2, Ascharya Balaji3, Jack H Casey4
1Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Vascular medicine (London, England)
|May 9, 2025
概括
在医疗记录中使用计费代码进行外围动脉疾病 (PAD) 的电子表型识别,通常依赖于不可靠的单代码查询. 改进这些方法对于使用电子健康记录和行政索赔数据进行高质量的研究至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 临床研究方法论 临床研究方法论
- 流行病学 流行病学
背景情况:
- 电子健康记录 (EHR) 和行政索赔数据库 (ACD) 越来越多地用于患者队列识别.
- 对外围动脉疾病 (PAD) 的表型方法的验证对于可靠的EHR和ACD数据利用至关重要.
研究的目的:
- 进行当代PAD观测研究的范围审查.
- 描述目前用于PAD识别的电子表型化策略.
- 提出改善PAD电子表型的建议.
主要方法:
- 在 MEDLINE 和 Web of Science 数据库中进行了搜索.
- 审查了748篇文章的标题和摘要,随后对163篇文章进行了全文审查.
- 包括84篇文章在电子表型方法的最终分析中.
主要成果:
- 大多数研究 (69.0%) 使用ICD-9和ICD-10代码的组合.
- 很高的百分比 (76.2%) 使用单代码查询,尽管诊断收益率低.
- 在21.4%的研究中使用了基于规则的方法,只有五项研究使用了逻辑回归建模.
结论:
- 目前用于PAD的电子表型化方法,特别是单代码查询,往往不可靠,并限制了研究质量.
- 需要在电子表型学方面进行显著的改进,以有效地利用EHR和ACD数据进行稳健的研究.
- 建议采用更复杂的方法,如物流回归.
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