老年急救应用研究标准化研究 (GEARSS):对老年急救病房患者的观察性研究
Ula Hwang1,2, Natalia Sifnugel1, Inessa Cohen3,4,5
1Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York, USA.
概括
多中心老年急诊护理研究发现,人口统计数据与前性和电子健康记录保持一致. 然而,诊断和思维因素的一致性较差,凸显了老年护理中的数据整合挑战.
科学领域:
- 老年急救医学的医学
- 医疗保健服务研究 医疗服务研究
- 在医疗保健中的数据科学.
背景情况:
- 在老年急诊部 (GED) 护理中的多中心研究是有限的.
- 老年急诊护理应用研究 (GEAR) 网络旨在通过跨学科合作推进GED护理.
- 建立强大的多中心研究基础设施对于改善紧急情况下对老年人的护理至关重要.
研究的目的:
- 创建一个多中心的研究库的前景和电子健康记录 (EHR) 数据为老年急诊护理.
- 评估预期收集的数据与老年急诊室人口中现有的EHR数据之间的一致性.
- 使用这个新型数据源,提供关于常见的老年综合征和疾病的初步发现.
主要方法:
- 在GEAR标准化研究 (GEARSS) 中,从3个机构的5个急诊室招募了999名老年人 (65岁以上).
- 数据收集的重点是老年友好护理的4M (移动性,药物安全性,思维,重要的事情) 和老年人虐待.
- 使用科恩的卡帕统计数据评估了前性数据和EHR数据之间的一致性.
主要成果:
- 种族,性别,年龄和种族等人口统计学变量显示,前性和EHR数据之间的一致性很好.
- 对应性对于处置来说相当,对于ED观察状态和痴呆症诊断来说微弱,对于妄想的存在来说差.
- 在几种慢性疾病的前性和EHR数据之间观察到显著差异 (>10%),包括类风湿病,胃潰瘍病,糖尿病,病和癌症.
结论:
- 人口统计数据表明,在老年急救护理研究中,预期收集和电子健康记录之间存在很强的对齐.
- 在诊断,处置和思维评估方面存在显著的不一致,这表明这些因素的数据集成存在挑战.
- 开发的多中心数据库为未来的GED研究提供了宝贵的资源,仔细考虑基于研究问题的数据源限制.
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